In the coming year, CMS has changed the structure of PQRS, meaningful use, and added new improvement activities. They have consolidated these programs into one called MIPS (Merit-based Incentive Payment System). Medicare reimbursement is tied to the performance in this program and if you do not participate in calendar year 2017 a 4% reduction will be applied to reimbursement from CMS during calendar year 2019.

There are some exclusions that allow providers not to participate. These include: if you are participating in an advance payment model; if you see less than or equal to 100 Medicare patients; or if you have less than $30,000 in allowable charges to Medicare. If you are part of the threshold exclusions you can participate, but you are not subject to the penalties.

In the first year, CMS has relaxed requirements and allowed for providers to report a minimum of a 90-day reporting period. In addition to that, to avoid penalties you must do one of the following: report one quality measure, one improvement activity, or the required measures of advancing care information (previously meaningful use).

This development period is temporary and the programs requirements will be enforced over time, making it more difficult to avoid penalties. Please refer to http://qpp.cms.gov for more information on the expected requirements of the program.

The above website also has full listings of all quality measures, step by step instructions as to what you need to do, information on reporting methods, and much more. Under the “Explore Measures” tab at the top of the page you can go through a step by step process to select your quality measures, advancing care information measures, and improvement activities and download them to an Excel spreadsheet for your use.