What is considered a small, rural, or underserved practice for the purposes of MIPS?
Modified Scoring in the MIPS Improvement Activities performance category in 2018
Groups with 15 or fewer participants or clinicians in a rural or HPSA will earn double points for each weighted improvement activity. So, medium-weighted activities will be worth 20 points and high-weighted activities will be worth 40 points.
With this flexibility, MIPS eligible clinicians in qualifying practices may complete up to 2 activities in order to achieve the maximum score in this performance category. CMS will access your eligibility for this status and make applicable scoring changes after you have submitted your PY 2018 MIPS data beginning in January 2019.
Modified Scoring in the MIPS Quality performance category in 2018
In 2018, the QCDR, qualified registry, and EHR submission mechanisms require at least 60% of all-payer patients or visits qualifying for the denominator of each measure to be reported in order to receive the full points based on the measure’s applicable benchmark. Normally, quality measures that don’t meet data completeness requirements (60% for 2018) will receive only 1 point, however, individuals and groups that meet the “small practice” definition will receive 3 points.
CMS support for small, rural and underserved practices
CMS offers specialized support opportunities for small, rural and underserved practices in an effort to help those practices navigate the Quality Payment Program without detracting from their focus on the needs of their patients. For more information on the participating technical assistance organizations and additional resources offered, please click here.