November 13, 2020

96% of MIPS Clinicians Qualified for Bonuses in 2021 Based Upon 2019 Performance

CMS recently released a blog post and infographic on preliminary participation data for the Quality Payment Program (QPP) in 2019.

For the Advanced APM track, 195,564 clinicians earned Qualifying APM Participant (QP) status to participate in the APM track, up from 183,306 in 2018. They'll receive the 5% lump sum bonus—QPP's reward for clinicians who participate in downside risk models like the Next Generation accountable care organization (ACO).  For the MIPS track, 954,604 clinicians participated in MIPS, down from 1.2 million clinicians in 2018. A significant portion performed well, with 83.69% earning a score above the exceptional performance threshold. Those clinicians will receive positive payment adjustments to their future Medicare Part B reimbursements, but the adjustments remain low.

In MIPS, positive payment adjustments were expected to be small for the 2021 payment year because CMS allowed providers to avoid penalties in MIPS if they were unable to submit data in response to the Covid-19 pandemic. Just 0.32% of MIPS eligible clinicians will receive a negative adjustment based on the 2019 program year. Because MIPS is budget-neutral, the few penalties being collected also limit the amount of positive adjustments that can be paid out.