Quality reporting

Cyberattack Prompts CMS to Extend 2023 MIPS Flexibilities - 03/19/2024

The Centers for Medicare & Medicaid Services recently announced two flexibilities related to Medicare’s Merit-Based Incentive Payment System 2023 performance year, citing the recent cyberattack on Change Healthcare and heeding advocacy by organized medicine.

Quality of Life: Pay-for-Quality Programs Increasingly Address Nonmedical Drivers of Health - 03/15/2024

Insurance payers seldom give physicians incentives to address nonmedical drivers of health, especially in traditional fee-for-service payer contracts. Those incentives remain rare even in pay-for-quality programs that emphasize value-based care, but they are gaining traction.

Reminder: Apply for 2023 MIPS Hardship Exemption by Jan. 2 - 11/28/2023

Physicians eligible to participate in Medicare’s Merit-Based Incentive Payment System may be spared a steep financial penalty, continuing a trend seen throughout the COVID-19 pandemic.

Feds Propose Information-Blocking ‘Disincentives’ - 11/14/2023

The U.S. Department of Health and Human Services released a proposed rule that would establish what it is calling “disincentives” that could amount to serious penalties for physicians and health care professionals found to have committed information blocking.

First-Ever MIPS Penalties Surface; Share Your Story With TMA - 10/16/2023

Given recent changes to Medicare’s Merit-Based Incentive Payment System (MIPS) and an ongoing push for Medicare physician payment reform, the Texas Medical Association encourages member physicians who participate in MIPS to closely review their final scores for the 2022 performance year.

Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 05/10/2023

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.

MIPS Value Pathways Registration Now Open - 04/25/2023

Physicians in search of an alternative to Medicare’s Merit-Based Incentive Payment System may be in luck.

Submit 2022 MIPS Data by March 31 to Avoid 9% Medicare Payment Cut - 03/28/2023

The data submission period for Medicare’s 2022 Merit-Based Incentive Payment System (MIPS) performance year is underway and closes on March 31 at 7 pm CT. At stake is a pay cut of up to 9% in the 2024 payment year.

Medicare Extends Deadline for MIPS Hardship Relief - 01/09/2023

Having some prohibitive trouble reporting your 2022 data for Medicare’s Merit-Based Incentive Payment System (MIPS)? Maybe the COVID-19 pandemic caused it. Maybe it stems from a natural disaster in your region. Maybe your technology vendor has gone out of business or had some other problem.

Watch for MIPS Data Validation and Audit Request - 12/14/2022

Physicians who participate in Medicare’s Merit-Based Incentive Payment System soon may receive a data-sharing request, or audit, as part of a legitimate federal oversight process, and compliance is required to avoid penalties.

MIPSperceptions: Study Confirms Doctors’ View of Medicare Program as Burdensome - 08/22/2022

Physicians’ perceptions of Medicare’s Merit-based Incentive Payment System (MIPS) have run along these and other unflattering lines since MIPS first launched in 2017. But a Physicians Foundation-funded study published in the Journal of General Internal Medicine sought to better quantify how physician practice leaders perceive MIPS, one of the two participation tracks in Medicare’s Quality Payment Program. (The Texas Medical Association has representation on the Physicians Foundation’s board of directors.)

CMS Debuts MIPS Final Score Preview Tool - 07/06/2022

Clinicians who are eligible to participate in Medicare’s Merit-Based Incentive Payment System now can sneak a peek at – and confirm the accuracy of – their final scores for the 2021 performance period.

The Power of Data: UTHealth Publishes Claims Statistics - 06/29/2022

After three years of work, the Center for Healthcare Data at McGovern Medical School at UTHealth is sharing part of its growing trove of numbers for data-driven discussions on many aspects of health care in Texas. The center doesn’t have all the answers. But its work under a federal certification from the Centers for Medicare & Medicaid Services (CMS) has resulted in valuable state and regional statistics that the center leaders believe provide food not only for thought, but also for policy.

CMS Debuting Optional Quality Reporting Mechanism, Amid Physician Concerns - 04/25/2022

Despite recent objections from the Texas Medical Association, Medicare’s Merit-Based Incentive Payment System (MIPS) will launch a new, optional reporting framework during the 2023 performance year.

TMA Backs Program to Help Small, Rural Practices With Quality Reporting - 04/05/2022

The Texas Medical Association is urging federal lawmakers to extend a technical assistance program for small practices in rural and underserved areas that participate in Medicare’s Quality Payment Program.

MIPS 2021 Data Submission Now Open - 04/05/2022

Participants in the 2021 performance year of the Quality Payment Program’s (QPP’s) Merit-Based Incentive Payment System (MIPS) can now submit their data through the QPP website. You can submit and update your MIPS data until 7 pm CT on March 31.

Congressional Watchdog Echoes TMA Concerns About MIPS - 10/13/2021

The Texas Medical Association has raised concerns about Medicare’s Merit-Based Incentive Payment System (MIPS) for years. Now, the U.S. Government Accountability Office (GAO), often called the congressional watchdog, has done the same.

2020 MIPS Scores, Feedback Now Available - 08/11/2021

Feedback and final scores for the 2020 performance year of Medicare’s Merit-Based Incentive Payment System (MIPS) are finally available online. And if you were one of last year’s MIPS participants, the Texas Medical Association urges you to check your score soon – because if you find an error that could affect your 2022 MIPS payment, you have only until Oct. 1 to request a review.

Medicare Eliminates Cost Category Factor in 2020 MIPS - 06/01/2021

Medicare is continuing to acknowledge recent extraordinary events in granting physicians relief from its Merit-Based Incentive Payment System (MIPS).

PEAQ Performance: Blues Program Shows Little Progress in Addressing Physicians’ Concerns - 05/31/2021

Blues performance recognition program shows little progress in addressing physicians’ concerns over such quality programs

Help TMA Standardize Quality Measures in Value-Based Care - 12/18/2020

Would you like a say in what measures should be a standard part of insurance quality programs across the nation – and which ones shouldn’t? The Texas Medical Association now has input in that discussion and could use your help.

Seeking a Measure of Reason: TMA Joins Collaborative to Standardize Quality Metrics - 03/31/2020

TMA joins collaborative seeking to identify and standardize quality metrics.

Submit 2019 QPP Data by March 31 to Avoid a 7% Medicare Payment Cut - 03/02/2020

The data submission period for Medicare’s 2019 Quality Payment Program (QPP) is under way and closes on March 31. If you haven’t started the process, now is the time to ensure your data for the Merit-Based Incentive Payment System (MIPS) is in order and submit it in time to make corrections by the deadline, if needed.

Supporting Fair APM Payments: AMA Backs Accounting for Social Determinants of Health - 01/02/2020

Alternative payment models (APMs) are considered a key part of the future of value-based care. But for them to be successful, the American Medical Association says, APMs need to be fair, which means adjusting for the circumstances that make physicians’ cost and care challenges unique.

Out of Physicians' Hands: TMA Challenges Unfair Quality Measures on Medication Adherence - 12/04/2019

Only patients can pick up their own prescriptions, and only patients can propel that medication into their own bodies. Physicians can educate, emphasize, and admonish – but at the end of the day, they can’t restrain and “pill” a squirming, uncooperative patient like a dog or cat. It’s up to patients to do the right thing for themselves. Yet, some health plans’ quality programs are putting that onus on physicians – through medication adherence metrics that determine whether physicians and accountable care organizations (ACOs) in value-based contracts receive bonus payments.