Do you want to avoid the MIPS penalty? Here’s how

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By Sabra Sullivan, MD, PhD
Chair, AADA’s Council on Government Affairs, Health Policy and Practice and the Congressional Policy Committee

We’ve heard from many members who are confused over MIPS reporting options. To put it simply, you have three reporting choices that will produce different financial outcomes:

  1. Avoid a penalty, but get no bonus
  2. Get a small bonus
  3. Get a modest bonus

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Avoid a penalty, but get no bonus

If you know that you or your practice must participate in MIPS for 2017 and you want to simply avoid the 4% penalty (penalty will be applied in 2019), all you have to do is report one quality measure on one patient before Dec. 31, 2017.

NOTE: If you choose this option, the AAD strongly recommends practices report more than one measure or report at least one measure over a 90-day period as an insurance policy in the event of submission issues or inaccuracies. Failure to correctly report one measure or activity in 2017 will result in a 4% penalty in 2019.

Here is how you can report one measure to avoid the 2019 payment penalty:

1.    Review the MIPS quality measures for dermatology on the Academy's 2017 quality measures page.

2.    Find one measure that is relevant to your practice and complete it on one patient before Dec. 31, 2017. Document that you completed the measure in your patient record. (Note:The AAD strongly recommends you report one measure on at least 20 patients as an insurance policy in the event of submission issues or inaccuracies.)

3.    Report that you performed this measure through ONE of the following methods:

a. DataDerm, the Academy's clinical data registry: Sign up now!
b. EHR vendor: contact your EHR vendor
c. Claims (only a small subset of quality measures are reportable through claims; there are no dermatology-specific quality measures reportable through claims): visit CMS' Quality Payment Program website, or call 1-866-288-8292 for more information.

Get a small bonus

The following option may allow for a "neutral or small positive payment adjustment".

Physicians may choose to submit one of the following options for any 90-day period beginning Jan. 1, 2017 through Oct. 2, 2017:

Get a modest bonus

This option may allow for a "modest positive payment adjustment". Please note that there are additional requirements for practices with more than 15 providers.

Physicians may choose to submit ALL of the following Quality Payment Program information for 90 days or the full calendar year:

  • Six quality measures in the quality performance category
  • One high-weighted improvement activity or two medium-weighted improvement activities
  • Five required measures making up the base score of the ACI category


MIPS resources

The Academy recently launched a new online resource center to help members prepare for the implementation of MACRA. The new MACRA section includes essential information for your practice, whether you’re reporting through Merit-based Incentive Payment System (MIPS), an alternative payment model (APM), or choosing not to participate in either.

This new resource center, which is free to Academy members, includes the following tools and resources to ensure members are on the right track to comply with MACRA:

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Learn about MACRA

Find a wealth of information and tools to help you understand and implement MIPS or APMs.

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MIPS and your bottom line tool

Find out how MIPS will impact your practice revenue with this interactive tool.

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MIPS reporting: A decision support tool

Is your practice ready for MIPS? Assess your readiness now with this tool.

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Find quality measures

Find dermatology-applicable measures to satisfy MIPS quality reporting requirements.

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Join AAD's MACRA community

Join an online discussion forum that allows members to ask staff experts questions about MACRA.



 

MACRA FAQs