CMS Releases Final 2018 QPP Performance Results: Max Positive 2020 Payment Adjustment is 1.68%

January 9, 2020
Policy Snapshot
Centers for Medicare and Medicaid (CMS), Payment, Alternative Payment Models (APM), Merit-Based Incentive Program Payment System (MIPS), Quality Payment Program (QPP), Practice Management, Practitioners

Last week, the Centers for Medicare & Medicaid Services (CMS) released the final 2018 Quality Payment Program (QPP) performance results for the Merit-based Incentive Payment System (MIPS), which impacts 2020 payments. The findings are summarized in a CMS blog post from CMS Administrator Seema Verma and in a CMS infographic. In late 2019, CMS released preliminary 2018 data.

Of note, the maximum positive MIPS payment adjustment a clinician will receive in 2020 is 1.68%, compared to the statutory maximum of 5%. MIPS is a budget neutral program. High participation rates in 2018 combined with a high percentage of clinicians avoiding a negative adjustment requires that the distribution of positive payment adjustments is spread across many people. This results in a lower overall positive payment adjustment.

Some other key findings for the 2018 performance year are:

  • 98% of eligible clinicians participating in MIPS will receive a positive payment adjustment in 2020, a 5% increase from 2019; and
  • 183,306 eligible clinicians earned Qualifying APM Participant (QP) status under the Advanced APM path while another 47 eligible clinicians received partial QP status during 2018

Additional information about the QPP can be found on the QPP webpage.