Avoiding the 2020 MIPS Payment Adjustment – The Minimum You Need to Report for 2018

QPP Tip of the Month

The “test” and “partial” participation options that were available for the CY 2017 MIPS participation period are no longer available for the CY 2018 MIPS participation period. To avoid the 2020 MIPS payment adjustment, based on 2018 MIPS participation, physicians will need a minimum of 15 points across all four MIPS categories – quality, improvement activities, promoting interoperability, and cost. Potential ways to achieve the minimum 15 points include:

  • 100 percent score in improvement activities category – reporting medium/high weight activities to achieve a total of 40 points
  • Achieving 18 points out of a total of 60 points (if reporting 6 measures) for the quality category
    • Reporting six measures for at least 60 percent of applicable patients
    • Earning the maximum 10 points for a high-performance score for at least two measures, which have benchmarks and are not “topped out” measures
  • Reporting the ACI base score measures and either:
    • Reporting at least one quality measure for at least 60 percent of applicable patients
    • Reporting one improvement activity
    • Receiving a small practice bonus
    • Receiving a complex patient bonus of at least three points

For additional information, please see Step 5 of the Navigating the QPP Resource  available on PAI’s MACRA QPP Resource Center.

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