Quality Reporting

Under the CMS Quality Payment Program (QPP)—the new reimbursement system that MACRA authorizes—the Physician Quality Reporting System (PQRS) will be replaced with the Merit-Based Incentive Payment System (MIPS), which also replaces the EHR Incentive Program (“Meaningful Use”).

Eligible professionals (EPs) will receive a score and payment adjustments based on a Final Score, which factors in performance on (1) quality, (2) cost, (3) improvement activities, and (4) advancing care information (formerly meaningful use of certified electronic health records (EHRs)). Fortunately, CMS has given practices 2017 to prepare for these changes, even dubbing the year as “Pick Your Pace.” To give physicians time to adapt to this new system, in 2017 CMS is requiring practices to report on only ONE measure to avoid a 4% Medicare reimbursement penalty in 2019. (While one measure is the minimum requirement to avoid the 2019 penalty, ASCO encourages practices to report on at least four measures to become fully acquainted with the system and ensure that the CMS requirements are met.)

Similar to QOPI's 2016 PQRS offerings, practices will be able to use the QOPI platform to meet the 2017 MIPS reporting requirements.

The 2017 MIPS reporting measure list for QOPI can be found below and more details on how to enroll in 2017 MIPS reporting with QOPI will be available soon. More information on how ASCO is helping to prepare practices for MACRA can be found here.

If you have any questions, please email QOPI@asco.org

2017 Reporting Timeline

January 1st, 2017 - December 31st*, 2017 - Reporting period for 2017 MIPS reporting.

       *October 2nd, 2017 - Practice participating in partial reporting must start no later than October 2nd, 2017 so as to report the full 90 day requirement.

January 2018 - March 2018 - QOPI will review, audit and packing data for CMS submission before the deadline of March 31st, 2018.

January 2019 - Payment adjustments begin

More detailed information is availabe on the CMS website.

PQRS Reporting Accordion

How to Get Started with 2017 MIPS Reporting

If you're interested in completing your 2017 MIPS reporting through the QOPI QCDR either via the Web-Interface Tool (manual data input) or the Systems Integrated electronic data submission method, please contact the QOPI Help Desk at qopi@asco.org to express your interest.

More information on how to register will be made available when the system has been officially launched.

How to Report Using the QOPI Web Interface Tool (WIT)

Reporting manually with the QOPI Web Interface Tool (WIT)

QOPI's Web Interface Tool (WIT) serves as QOPI's manual reporting option for 2017 MIPS reporting and QOPI's Qualified Registry. For practices who aren’t ready to reporting electronically, the QOPI WIT can be used to satisfy 2017 MIPS reporting requirements by submitting one or more MIPS quality measures from the list below to avoid the 4% 2019 payment penalty for non-reporting.

While reporting one measure on one patient is the minimum requirement to avoid the 2019 penalty, ASCO encourages practices to report several quality measures with several patients per measure to become fully acquainted with the system and ensure that CMS requirements are met. At least one of these patients for at least one measure must be a Medicare beneficiary.

Alternatively, the “one patient, one measure,” requirement can also be fulfilled by reporting one improvement activity or achieving the base score of the ACI category instead of reporting quality measures. Please note that practices participating in the Oncology Care Model (OCM) with one-sided risk are exempt from the quality component of MIPS. For more details on the OCM and other MIPS reporting options, please visit http://www.asco.org/macra

Information on signing up for the QOPI WIT will be posted here in the near future.

How To Report Electronically through QOPI's Qualified Clinical Data Registry (QCDR)

COMING SOON!

Measure Selection for 2017 MIPS Reporting

For the 2017 performance year, under the “pick your pace” schedule, you may report as little as one measure on one patient to avoid the payment penalty, although it is recommended that you submit more data to ensure successful avoidance of the penalty. Please note, if you choose to participate in minimum reporting, the patient must be a Medicare Part B patient.

For providers looking to increase their MIPS quality score and participate fully in quality reporting, CMS requires a reporting minimum of 6 measures or a specialty measure set (these sets may include more or less than 6 measures) for at least 90 days; you may report up to a full year. Practices or individuals should pick the measures that are most applicable to their practices, one of which should be an outcome measure (or a high priority measure if an outcome measure is not available and applicable). To ensure complete scoring of a measure (i.e. to potentially receive more than the 3 points which is the floor for 2017), you must report on 50% of all your patients to whom the measure applies, and have a 20 patient minimum. 

The QOPI QCDR contains measures from CMS’s General Oncology Specialty Measure Set and has been approved by CMS for quality reporting through a registry for 2017. The approved measure list is below.

2019 Payment Adjustment Information

Your practice's 2019 payment adjust will depend on how you participate for the 2017 reporting year as well as how your practice performs compared to the rest of 2017 reporting practices.

For Group Practices

You may report as a group for MIPS in 2017. A group is defined by CMS as a set of clinicians (identified by their NPIs) sharing a common Tax Identification Number (TIN), no matter the specialty or practice site. Note that if you choose the group reporting option you must report as a group across all categories (for 2017 that includes Quality, Advancing Care Information, and Improvement Activities; cost is not part of your MIPS score for the 2017 performance year).

No registration with CMS is necessary to report as a group, unless the group plans on using the CMS Web Interface for group reporting, in which case you must register with CMS by June 30, 2017 (see here https://qpp.cms.gov/docs/QPP_Web_Interface_Registration_Guide.pdf for more information). If you choose the group reporting option all clinicians in the group will receive the same score and the same payment adjustment in 2019.