Ventra is reaching out to share important information and upcoming deadlines regarding MIPS Reporting. As the 2024 program year comes to a close, several vital deadlines are approaching.

2023 Final Scores and Payment Adjustments

CMS recently shared information regarding the 2023 Final Scores. The average final score for 2023 was 82.91 for a .56% positive payment adjustment. The maximum positive payment adjustment for 2023 is +2.15%. CMS will release detailed information in Spring 2025.

Extreme and Uncontrollable Circumstances (EUC) Waiver Deadline

Suppose you have been affected by a significant disaster or another uncontrollable event. In that case, you can apply for an EUC waiver to reweight your MIPS performance categories. The deadline to apply for the 2024 performance year is January 2, 2024. EUC exceptions are intended to assist providers facing rare and unforeseen events beyond their control.

Here are some examples of circumstances that typically qualify for an EUC exception:

• Natural Disasters: Events like hurricanes, floods, earthquakes, and wildfires that disrupt normal operations and make it impossible to collect or submit necessary data.
• Public Health Emergencies: Situations like pandemics or widespread outbreaks significantly impact healthcare delivery and data collection.
• Practice Closures: Unexpected practice closures due to reasons beyond the provider’s control, such as severe financial distress or vendor issues.
• Data Breaches: Situations like Change Healthcare or Ascension in 2024
• Loss of Electronic Health Record (EHR) Technology: Situations where a provider’s EHR system is decertified or fails, making it impossible to collect or submit data.
• Insufficient Internet Connectivity: Lack of reliable Internet access that prevents the submission of required information.

Exceptions offer crucial relief by allowing providers to request reweighting for any or all MIPS performance categories. This process helps ease the burden during difficult times, enabling you to concentrate on patient care. All supporting documentation must be kept for six years in case of a CMS audit of the EUC waiver.

MIPS Value Pathway (MVP) Deadline

Register between April 1, 2024, and December 2, 2024, if you plan to report through a MIPS Value Pathway. This newer voluntary reporting option helps you fulfill MIPS requirements.

Participating in an MIPS Value Pathway (MVP) can benefit provider groups, contributing to a more efficient and effective healthcare system.

• Simplified Reporting: MVPs streamline MIPS reporting by aligning measures and activities across different performance categories (Quality, Cost, Promoting Interoperability, and Improvement Activities). This reduces the complexity and burden of reporting.
• Relevance to Specialty: MVPs are designed to be more relevant to specific specialties or medical conditions. This means the measures and activities are tailored to the particular scope of practice, making participation more meaningful and applicable.
• Enhanced Data and Feedback: Participating in an MVP provides provider groups with enhanced data and feedback, which can help improve patient care and outcomes.
• Reduced Burden: The framework aims to reduce clinicians’ administrative burden by leveraging administrative claims-based measures and population health priorities.
• Alignment with APMs: MVPs help ease the transition between MIPS and Alternative Payment Models (APMs), creating a more cohesive experience and ensuring you’re on the right track.
• Improved Patient Outcomes: MVPs aim to improve health outcomes and lower patient costs by focusing on meaningful measures of patient care.
• Informed Decision-Making: The framework provides comparable performance data that helps patients make more informed healthcare decisions.

Consult your medical association for specific guidance on specialty-specific MVPs. MVPs are available for Emergency Medicine, Anesthesia, Hospital Medicine, and Radiology.

Automatic EUC for Natural Disasters

Suppose you are located in a region designated by CMS that is affected by a natural disaster. In that case, you may automatically qualify for an Extreme and Uncontrollable Circumstances (EUC) exception.

If a significant disaster designated by FEMA impacts your area, you will not need to submit a separate application. Please verify whether you are eligible to receive an automatic EUC exception from CMS due to the natural disaster.

Follow these steps:

• Check if your area is affected: Verify if your location is within a CMS-designated region impacted by a natural disaster. CMS typically aligns with major disaster areas designated by FEMA.
• Confirm the disaster type: Ensure the event is classified as an extreme and uncontrollable circumstance, such as hurricanes, floods, earthquakes, or other significant natural disasters.
• Automatic qualification: If your area meets the criteria, you will automatically qualify for the EUC exception. You won’t need to submit a separate application.
• Stay informed: Watch official CMS announcements and updates regarding affected regions and any changes to the policy.

Wrapping-Up!

Meeting deadlines is crucial to avoid penalties or issues with your MIPS reporting. Missing these dates may contribute to not optimizing your MIPS reporting. Download this calendar to help you stay up to date with important deadlines.

2025 MIPS is Coming

As we approach the end of the year, it’s essential to start thinking about your MIPS plans for 2025. The Centers for Medicare & Medicaid Services (CMS) will soon release the final rule for the 2025 Physician Fee Schedule (PFS), which includes MIPS. This final rule is expected to mirror the proposed rule released in the summer closely.

Ventra will keep you up to date on all things MIPS, so stay tuned for more information and join our webinar on December 10 at 3 PM CT.