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Darren O'Brien

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Darren O'Brien

2021 Changes to the Quality Payment Program: Must-Know Guidelines for ACOs

In 2021, CMS proposes the following four key changes to the Quality Payment Program (QPP) that will impact quality measurement for ACOs and ACO participants:

The discontinuation of the CMS Web Interface.
The introduction of the alternative payment model (APM) Performance Pathway (APP).
The discontinuation of the APM scoring card.
The addition of the APM entity as a submitter type for MIPS.

Each change will create new challenges for ACOs and ACO participants. Organizations can successfully navigate these shifts by partnering with a robust quality measures solution that creates a complete picture by combining comprehensive data and measures information in performance visualizations. An inclusive quality measures solution also creates a thorough workflow by combining the monitoring and improving processes, then submitting performance to payers.

Darren O'Brien

The Complete Guide to MIPS 2021: Scoring, Payment Adjustments, Measures, and Reporting Frameworks

This resource is a comprehensive guide to 2021 updates to Merit-based Incentive Payment System (MIPS) quality measures. This guide will help increase your understanding of MIPS quality measures so you can choose the best quality measures for your team. Learn about important updates to MIPS for 2021, including:

Four significant scoring changes for MIPS 2021.
How CMS weights MIPS categories differently for different MIPS reporting frameworks.
New MIPS scoring hierarchy.
And much more.

Darren O'Brien

Complete Guide to the APM Performance Pathway (APP) for MIPS APM Participants and ACOs

In the 2021 Final Rule, CMS introduced a new and streamlined QPP reporting framework for both MIPS APM participants and ACOs. (Note: a MIPS APM participant is a clinician that participates in an APM but does not qualify as an advanced-APM participant, meaning the clinician is not exempt from MIPS.) The new reporting framework is the APM Performance Pathway (APP). The APP is optional for all MIPS APM participants but required for ACOs participating in the Medicare Shared Savings Program (MSSP).

Rachel Katz
Darren O'Brien

A Complete Guide to MIPS Quality Measures

This comprehensive guide includes 12 frequently asked questions about Merit-based Incentive Payment System (MIPS) quality measures. This guide will help increase your understanding of MIPS quality measures so you can choose the best quality measures for your team. Find answers to your questions, including:

Where can I find a list of MIPS quality measures?
What are specialty measure sets and how do they categorize MIPS quality measures?
What are submission methods for MIPS quality measures?
How are benchmarks used to score your performance in MIPS quality measures?
What is the burden of different MIPS quality measures?

Darren O'Brien

Complete Guide to MIPS Value Pathways (MVPs)

In the 2020 Final Rule, CMS confirmed MIPS Value Pathways (MVPs) as the “future state” of MIPS. MVPs would significantly change the way clinicians participate in MIPS starting in MIPS 2021. This guide explains that transformation.
This guide answers these questions:

What are MIPS Value Pathways?
Will CMS make MIPS Value Pathways mandatory or optional?
When will CMS implement MIPS Value Pathways?
Why is CMS moving to MIPS Value Pathways?
How would MIPS change with MIPS Value Pathways?