Since its inception on January 1, 2017, the Quality Payment Program has been driving healthcare forward, encouraging meaningful clinician participation and improving patient outcomes. Each year, the program undergoes evaluations and modifications to align with evolving healthcare trends.
In this guide, we will focus on the updates relevant to the Traditional Merit-Based Incentive Program System (MIPS) for 2023.
Eligibility and requirements
To participate in the Traditional MIPS program for 2023, eligible clinicians (EC) must meet the following criteria:
- Be a MIPS-eligible clinician
- Exceed the low-volume threshold as an individual or group
- Not identify as a Qualifying APM Participant (QP)
- Use Certified Electronic Health Record Technology (CEHRT)
Performance threshold
The performance threshold, which determines the minimum number of points required to avoid penalties, remains unchanged. For 2023, the performance threshold is set at 75 points. The exceptional performance threshold has been discontinued, eliminating additional incentives for providers who exceed the 75-point threshold.
Performance category weights
The performance category weights for the 2023 performance year remain consistent. They are as follows:
- Quality Performance Category: 30%
- Cost Performance Category: 30%
- Improvement Activities Performance Category: 15%
- Promoting Interoperability Performance Category: 25%
Streamline reporting with Tebra’s advanced dashboards
Tebra offers robust solutions to help healthcare providers navigate the updated Promoting Interoperability (PI) requirements for 2023. Take advantage of Tebra’s advanced dashboards tailored to meet the following updates.
Automatic reweighting changes
Nurse practitioners, physician assistants, certified registered nurse anesthetists, and clinical nurse specialists are now required to report PI data unless they qualify for reweighting due to a special status or an approved Hardship Exception Application.
Clinical social workers, physical therapists, occupational therapists, qualified speech-language pathologists, qualified audiologists, clinical psychologists, registered dieticians, and nutrition professionals will continue to have PI automatically reweighted. Ambulatory surgical centers (ASC), hospital-based, non-patient facing practices, and small practices (15 or fewer clinicians) will also undergo reweighting. If data is submitted, the reweighing will be ignored and the data will be evaluated and scored accordingly
Expanded Prescription Drug Monitoring Program (PDMP) measure
The PDMP measure now includes Schedule III and IV drugs, in addition to Schedule II opioids. Tebra’s EHR software allows providers to conduct queries of the PDMP, even without integration with local or state PDMPs. Providers can indicate compliance through a simple Yes/No response. Exclusions exist for this measure based on state law, integration feasibility, or low prescription volumes.
Increased emphasis on public health measures
The ONC (Office of the National Coordinator for Health Information Technology) has reweighted the PI category to place greater emphasis on public health measures. Providers who meet the public health measures receive 25 points, while health information exchange measures carry a reweighted value of 15 points each. Tebra’s EHR software supports seamless integration and efficient reporting for public health outcomes.
Simplify quality reporting with Tebra’s EHR solutions
Tebra supports a group of 20 electronic clinical quality measures (eCQMs) in response to the elimination of two measures from Traditional MIPS. The removed measures are CMS 147: Preventive Care and Screening: Influenza Immunization and CMS 127: Pneumococcal Vaccination Status for Older Adults. Providers can conveniently document quality initiatives within Tebra’s EHR.
Don’t let the complexity of MIPS updates overwhelm your independent practice. Take advantage of Tebra’s expertise and innovative EHR solutions to streamline your MIPS reporting and drive improved patient outcomes. Contact us today to learn more about how Tebra can help you succeed in the MIPS program for 2023.