Preparing your 2024 reporting strategy involves understanding the Merit-Based Incentive Payment System (MIPS) and the ongoing changes for clinicians. Review the following quality payment program updates for your 2024 reporting year to ensure you get paid for your Medicaid services.
Quality Payment Program: Key Updates in 2024
- Merit-based Incentive Payment System (MIPS)
- Advanced Alternative Payment Models (APMs)
- Quality,
- Clinical Practice Improvement Activities (referred to as “Improvement Activities”),
- Certified EHR Technology (referred to as “Advancing Care Information”), and
- Resource Use (referred to as “Cost”).
| Weight for Standard | Weight for Small Practice (those with 15 or fewer clinicians) | Changes in 2024 | |
| Quality | 30% | 50% | No significant changes in scoring/reporting. |
| Cost | 30% | 30% | Allocating 30% of the total score to the cost performance category. |
| Interoperability | 25% | null | Allocating 15% of the total score to the IA performance category. |
| Improvement Activity | 15% | 20% | Increase from a minimum of 90 continuous days to a minimum of 180 continuous days. |
| 2024 Final Score | 2026 Adjustment Score |
| 0.0-18.75 | Negative 9% |
| 18.76-74.99 | Negative MIPS payment adjustment greater than negative 9% and less than 0% on a linear sliding scale |
| 75.0 | 0% adjustment |
| 75.01-100 | Positive MIPS payment adjustment greater than 0% on a linear sliding scale. The linear sliding scale ranges from 0 to 9% for scores from 75.00 to 100.00 This sliding scale is multiplied by a scaling factor greater than zero but not exceeding 3.0 to preserve budget neutrality. |
Changes to Performance Categories
Clinical Quality Measures or Medicare CQM Performance Category and Data Completeness Threshold
- Electronic Clinical Quality Measures (eCQMs)
- MIPS CQM
- Qualified Clinical Data Registry (QCDR) measures
- Medicare Part B claims measures
Improvement Activities
Improvement Activities account for 15% of the total MIPS score in the performance year 2024. Here are the changes for the improvement activities in the 2024 MIPS performance year:
- CMS has expanded the reporting criteria for improvement activities as a way to streamline and simplify reporting requirements and make it easier for clinicians to participate in MIPS.
- New improvement activities have also been added under eligible criteria, and these include activities towards telehealth, care coordination, and patient engagement.
Cost Measure Performance Category
The Improved Cost Measure Performance Category applies only to clinicians using traditional MIPS reporting and is categorized as 0% for clinicians reporting via APM performance pathway.
There are 25 cost measures available for this performance period, which include a range of procedures, chronic conditions, acute inpatient medical conditions, and chronic conditions, and population-based cost measures focused broadly on primary and inpatient care.
Promoting Interoperability Performance Category
Changes to Payment Models & Timelines
Medicaid Alternative Payment Model and Advanced Alternative Payment Model
- The APM requires participants to use certified EHR technology.
- The APM bases payment on quality measures comparable to those in the MIPS quality performance category.
- The APM either: (1) requires APM entities to bear more than nominal financial risk for monetary losses OR (2) is a Medical Home Model expanded under Center for Medicare & Medicaid Innovation Authority (CMMI).
Medicare Physician Fee Schedule 2024
New Timelines for Requesting Targeted Review
CMS will open the targeted review submission period upon release of the MIPS final scores and keep it open for 30 days after MIPS payment adjustments are released. This would maintain an approximately 60-day period for requesting a targeted review.
2024 MIPS Payment Adjustment
Safely Navigate the 2024 Quality Payment Program Updates With CareTracker
Practices can stay on top of all these changes with practice management software and Electronic Health Records (EHR) can simplify MIPS reporting, data collection, and analysis.
These tools provide a systematic way to monitor performance metrics, identify areas for improvement, and ensure seamless compliance with evolving QPP requirements.
For personalized guidance and consultation on optimizing your reporting strategy, contact Harris CareTracker today. Our experts can help you navigate healthcare reporting, monitor regulatory changes, and excel in QPP participation.
Reach out to us for a consultation or to get more information on how Harris CareTracker can empower your practice in the ever-evolving world of healthcare.
