When it comes to the Quality Payment Program participation, what you don’t know can negatively impact your reimbursement. Let’s review three significant changes for 2022.
1. Removal of the Extreme and Uncontrollable Circumstances (EUC) Policy
COVID-19 EUC hardship provision gave providers some leeway with the usually rigid scoring. To request reweighting of scoring categories will no longer be an option as this was not renewed for 2022.
2. Increased Performance Thresholds
Just five years ago, MIPS quality threshold was set at three points, and 75 points for exceptional care. What was once considered a top-performing score (75 pts.) is now the bare minimum to avoid a penalty. 89 points is the new threshold to earn a positive adjustment.
3. Quality and Cost Categories Will Now Be Rated Equally
Quality and Cost categories will be weighted equally at 30% each – a change mandated in the original Medicare Access and Chip Reauthorization Act of 2015 (MACRA) legislation. Naturally, this results in an overhaul of your existing quality and cost management strategy.”
With over two decades of experience, Medical Advantage has seen it all when it comes to CMS and MACRA. For help adjusting to these and future CMS changes, reach out to us! We’re here to help you.