3 Critical Value-Based Care Program Updates for MIPS, APMs & Maryland EQIP

CMS Releases New 2021 MIPS Historical Quality Benchmark File Due to Errors

The Centers for Medicare & Medicaid Services (CMS) recently released a new 2021 Merit-based Incentive Payment System (MIPS) historical quality measure benchmark file (.ZIP) due to the discovery of a miscalculation with the decile outputs affecting every historical measure benchmark in the files released earlier in 2021. The issue affects every measure in the 2021 benchmarks file and has now been corrected with the June 2021 updated release. As a result of the correction, the range of performance rates for a given decile have shifted down one decile. Read more from the AMA.

Medicare Alternative Payment Model Incentive Payments are En Route

CMS is now issuing incentive payments to physicians who qualified for them through their participation in advanced Alternative Payment Models (APMs) during 2019. As required by the 2015 MACRA law, the lump sum incentive payments are set to equal 5% of the qualifying physicians’ Medicare fee-for-service revenues. The AMA and others have long criticized the lengthy delay in making these payments, which in previous years were not distributed until the fall. This is the first time that they have been paid in the second quarter—a significant improvement, although still long after the APM participation period. Read more from the AMA.

Maryland’s Episode Quality Improvement Program Enrollment Began July 9th

The Episode Quality Improvement Program (EQIP) is an episode-based payment program for non-hospital physicians designed to include more episodes than in the CMMI model and broaden access to Medicare’s 5% Advanced APM MACRA opportunity. It also aims to help Maryland meet the financial targets of the Total Cost of Care (TCOC) Model, include more physicians in a value-based payment framework, and encourage multi-payer alignment in a value-based payment framework.

The first performance year of EQIP will cover a range of initial clinical episodes in the specialty areas of cardiology, gastrointestinal, and orthopaedics. Enrollment for EQIP began July 9th, 2021 and ends September 1, 2021 with a targeted performance year start of January 1, 2022. Apply now or learn more.