Quality reporting

UPDATE: Submit 2024 MIPS Data by April 14 to Avoid 9% Pay Cut - 03/28/2025

The data submission period for Medicare’s 2024 Merit-Based Incentive Payment System (MIPS) performance year is underway and closes on April 14 at 7 pm CT. At stake is a pay cut of up to 9% in the 2026 payment year.

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.

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.

More Pain for Small Shops? 2020 Quality Program Rule Could Mean More Penalties - 10/01/2019

Small and solo practices already take the worst of the administrative and financial pounding the Quality Payment Program (QPP) dishes out each year. In the Texas Medical Association’s analysis, the government’s plans for the QPP in 2020 would make the situation even harder on those smaller shops. Since QPP’s birth in 2017, small practices have struggled with the demands and synapse-straining complexities of the program’s Merit-Based Incentive Payment System (MIPS). And TMA analysis shows the payment penalties those “have-not” practices incur fund the bonus payments earned by MIPS “haves” – often, larger practices with the resources to make the program work. Under the 2020 changes that the Centers for Medicare & Medicaid Services (CMS) has proposed, the maximum penalties for practices who don’t hit their MIPS targets will be larger than ever. But TMA’s review shows that MIPS – despite CMS’ claims to the contrary – isn’t getting any simpler.

Anybody There? Physicians Unfairly Penalized for AWOL Medicare Advantage Patients - 09/04/2019

You’ve tried and tried and tried. Phone calls, emails – nothing. A Medicare Advantage plan assigned you a patient who didn’t choose you, and the patient is driving that point home – by ignoring you. Or maybe the contact information the plan gave you is out of date, and the patient’s latest phone number or email is unknown. Either way, your as-yet-unseen patient is AWOL – and you can be penalized for it on health plans’ quality ratings, which ultimately can affect payments. New Texas Medical Association policy takes aim at the unfairness this lack of patient response can present for physicians, while opening up an opportunity for medicine to work with health plans to solve the problem.