2025 MIPS Proposed Rule is trying to make it easier on practices - Part 2
By ION
CMS released its Proposed Rule for MIPS for the upcoming year, and several of their proposed plans could benefit your practice. In this, we will highlight the changes to Quality and Cost measures:
Quality: CMS proposes to maintain the 75% data completeness through 2028, not making it any harder for you practice collecting more data. The agency did add and remove some measures and proposed updates for 60+ measures with substantive changes. As an example – for measure 450 for “Appropriate treatment for patients with stage 1 (T 1c)-III HER2 positive breast cancer,” CMS is adding male breast cancer. Another example – under measure 176, CMS updated their list of medications on screening for tuberculosis including adding new biosimilars. The complete list of measures and changes can be found in the Proposed Rule PDF version in Table Group D.
In addition, CMS is proposing changes to the benchmarking for topped out measures, moving to a flat rate benchmark. If your practice missed a patient in measuring, in prior years, your performance rate may have dropped significantly (possibly by 50% of a drop in points). With the proposed scoring, that one patient may only make a difference of 10-20% in points. That “leveling out” or proposed “flat rate” of benchmarks offers your practice a way to improve scoring. This is one area where the MIPS team encourages you to comment on the proposed plan.
Cost: While there may be little you can do to improve Cost scoring as it related to claims data, CMS is considering changes to the Cost measuring benchmark. Example – while the total cost for care from your practice may not be significantly above compared to the national average, the change in a measurement point drop could be significant. The proposed change to benchmarking should benefit practices and providers with this change in their scoring methodology.
CMS is also considering implementing criteria on how measures are removed from the program, also looking at whether the benefit of retaining a measure will outweigh the benefit of removing.
The Quality Reporting Engagement Group is encouraging all practices to comment on the proposed changes – even those which could benefit your practice. The last day to submit comments is September 9, 2024. Comments can be submitted at: https://www.regulations.gov/ (in commenting please refer to file code CMS-1807-P).
The QREG consulting team has over 75+ years of combined experience, has worked with nearly 20 specialties in over 220 practices, with an exceptional performer rate of over 98% for all clinicians since 2017. For information on contracting with them, email info@intrinsiq.com or call (877) 570-8721.
Watch the recent webinar hosted by the MIPS consulting services group
