In the Headlines
July 25, 2022

New Model for MIPS is Coming, While Advanced APMs Get a Tough Break

Part B News

Senior Public Affairs Advisor Suzanne Joy was quoted in a Part B News article about the changes to the Quality Payment Program (QPP) and Merit-based Incentive Payment System (MIPS). The Center for Medicare and Medicaid Services (CMS) is shifting focus onto the MIPS Value Pathways (MVP) that begins on a voluntary basis in 2023. This change poses concerns for Advanced Alternate Payment Models (AAPM) participants in the QPP because it eliminates one of the major appeals of the program, the 5 percent lump sum of  a qualifying provider's estimated aggregate payment amount for covered professional services. The proposed replacement would not begin until the 2024 performance year, leaving a one-year gap. Ms. Joy noted that Congress could extend the lump sum as a result of the one-year gap.

"I do know there's an active push to get it included in an end-of-year physician spending package and it's supported by some pretty influential groups [like the AMA]. Because it's a one-year gap, I think that there’s a pretty reasonable chance Congress might act to at least extend [the lump sum] one year," explained Ms. Joy.

READ: New Model for MIPS is Coming, While Advanced APMs Get a Tough Break (Subscription required)

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