CMS Releases 2017 Quality Payment Program Experience Report

March 22, 2019
Policy Snapshot
Centers for Medicare and Medicaid (CMS), Alternative Payment Models (APM), Medicare Access and CHIP Re-authorization Act (MACRA), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners

This week the Centers for Medicare & Medicaid Services (CMS) released its 2017 Quality Payment Program (QPP) Experience Report with Appendix, which provides a comprehensive overview of the clinician reporting experience during the first year of the QPP. This report expands on the initial performance results shared by Administrator Seema Verma in November 2018.

Data within the report show significant participation and performance in both the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Model (APM) tracks for the 2017 performance year. Key 2017 findings include:

  • Of the 1,057,824 clinicians eligible for MIPS, 1,006,319 (95 percent) participated in MIPS and avoided a negative payment adjustment.
  • 341,220 MIPS-eligible clinicians participated in MIPS through a MIPS APM, which, combined with the above results on QP status, indicates a desire from clinicians and practices to transition toward value-based arrangements.
  • Most eligible clinicians (93 percent) who participated in MIPS earned a positive payment adjustment and 2 percent earned a neutral adjustment.
  • Of the eligible clinicians who participated in MIPS, 54 percent did so as groups, 12 percent as individuals, and 34 percent through MIPS APMs.
  • Across all of the MIPS performance categories, the majority of MIPS-eligible clinicians opted to report data for 90 days or longer; less than 1 percent elected to submit the minimum amount of data and report for less than 90 days.
  • MIPS-eligible clinicians who were in small or rural practices had participation rates of 81 percent and 94 percent, respectively.
  • A total of 99,076 clinicians were Advanced APM Qualifying Participants (QPs) and an additional 52 were Partial QPs.

The report also highlights data on participation rates and mean and median scores, detailed by categories such as reporting type (individual, group, or APM), clinician type, group size, and special status. Additionally, the report shares the amount of data clinicians chose to submit, the ways they submitted data, and the most commonly reported quality measures.

Please note that based on feedback, CMS presented the data in the QPP Experience Report in a concise way to highlight the elements that practitioners have indicated are important in understanding the entirety of the program. Additional and more extensive data can be found in the appendix of the report.

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