One patient, one measure, no penalty

This is the first year physicians will need to report on quality measures under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS). You can pick your pace of reporting for 2017 under the Merit-based Incentive Payment System (MIPS) of the QPP.

View this video to learn how to avoid a negative 4% payment adjustment in 2019 by reporting on one measure for one patient via CMS’ claim form before the end of 2017.

VIDEO: One patient, one measure, no penalty: Avoid Medicare penalties

Use the step-by-step guide to supplement the video.

PDF 1: Step-by-step guide to avoiding Medicare payment penalties

PDF 2: CMS-1500 Claim MIPS Quality example

Quality measure tools

Use CMS’ Quality Measure Search tool to find a relevant measure to report on and make note of its 3-digit quality ID number.

The ID number can be used to find the measure specifications document within the zip file from CMS’ Quality Measure Specifications page.

After downloading the zip file to your computer, find a folder called “QPP_Quality_measure_specifications” to access documents corresponding to individual measure specifications. Find and open the claim measure specification, not the registry measure specification.

LINK 1: CMS’ Quality Measure Search

LINK 2: Quality Payment Program resource library

First check MIPS eligibility

Several exemptions exist. Enter a national provider identifier (NPI) into CMS’ tool to determine if you should participate in MIPS in 2017. Exemptions include those for physicians with less than $30,000 in Medicare payments or fewer than 100 Medicare patients, who are new to Medicare in 2017, who participate in advanced alternative payment models, etc. 

LINK 3: QPP participation status

In the case of hardship, such as insufficient internet connectivity, extreme and uncontrollable circumstances, or lack of control over the availability of Certified EHR Technology, some MIPS-eligible clinicians can use the advancing care information hardship exception application for 2017.

LINK 4: About exception applications

What to do next for QPP

LINK 5: Related Links: What to do next for QPP

One patient, one measure, no penalty

This is the first year physicians will need to report on quality measures under the new Quality Payment Program (QPP) from the Centers for Medicare and Medicaid Services (CMS). You can pick your pace of reporting for 2017 under the Merit-based Incentive Payment System (MIPS) of the QPP.

View this video to learn how to avoid a negative 4% payment adjustment in 2019 by reporting on one measure for one patient via CMS’ claim form before the end of 2017.

VIDEO: One patient, one measure, no penalty: Avoid Medicare penalties

Use the step-by-step guide to supplement the video.

PDF 1: Step-by-step guide to avoiding Medicare payment penalties

PDF 2: CMS-1500 Claim MIPS Quality example

Quality measure tools

Use CMS’ Quality Measure Search tool to find a relevant measure to report on and make note of its 3-digit quality ID number.

The ID number can be used to find the measure specifications document within the zip file from CMS’ Quality Measure Specifications page.

After downloading the zip file to your computer, find a folder called “QPP_Quality_measure_specifications” to access documents corresponding to individual measure specifications. Find and open the claim measure specification, not the registry measure specification.

LINK 1: CMS’ Quality Measure Search

LINK 2: Quality Payment Program resource library

First check MIPS eligibility

Several exemptions exist. Enter a national provider identifier (NPI) into CMS’ tool to determine if you should participate in MIPS in 2017. Exemptions include those for physicians with less than $30,000 in Medicare payments or fewer than 100 Medicare patients, who are new to Medicare in 2017, who participate in advanced alternative payment models, etc. 

LINK 3: QPP participation status

In the case of hardship, such as insufficient internet connectivity, extreme and uncontrollable circumstances, or lack of control over the availability of Certified EHR Technology, some MIPS-eligible clinicians can use the advancing care information hardship exception application for 2017.

LINK 4: About exception applications

What to do next for QPP

LINK 5: Related Links: What to do next for QPP

VIDEO: One patient, one measure, no penalty: Avoid Medicare penalties

One patient, one measure, no penalty: Avoid Medicare penalties

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Why Join the AMA?

An AMA membership means you’ve got access to world-class clinical research, education and insights. Access peer-reviewed medical research findings and editorial opinions from JAMA®, the Journal of the American Medical Association, JAMA Network Open™ and the 11 specialty journals, with CME at no cost.

Join Now