As we approach the end of the year, rehab therapists everywhere are (hopefully) busy squaring away all of their compliance plans—including those having to do with quality data reporting—for 2017 and beyond. And for the last several years, those plans have included provisions for successfully completing PQRS. This year, however, is a different story: Medicare released its Final Rule earlier this month, and amidst the 1,400-plus pages of pure gobbledygook, CMS indicated that PQRS is officially coming to an end at the conclusion of 2016. And with PQRS off the table, some of you might be breathing a heavy sigh of relief.

On top of that, the Merit-based Incentive Payment System (MIPS)—which is the program that, starting next year, will replace not only PQRS, but also Meaningful Use and the Value-Based Modifier (VM) program—won’t allow for PT, OT, and SLP participation until at least 2019. Wait a sec—rehab specialists can wait a whole two years before they must resume collecting quality data? That’s a big 10-4.

So, what’s a PT, OT, or SLP to do if he or she wants to stay in the quality data-reporting habit? And is it actually worthwhile to do so? After all, now that PQRS is no more, there’s no financial incentive associated with continued reporting. If these burning questions—not to mention all the impending holiday stress—have you in a tizzy, take a moment to breathe. We’re here to help. Here’s the 4-1-1 on quality data reporting in 2017:

Unwrapping MIPS and the Final Rule: How to Prepare for 2019 - Regular BannerUnwrapping MIPS and the Final Rule: How to Prepare for 2019 - Small Banner

You can continue quality reporting—on a voluntary basis

Concerned you’ll lose your quality reporting edge during the rehab industry’s two-year MIPS reprieve? Well, you’re in luck. You can essentially take MIPS for a test drive (yes, we talkin’ about practice) during the first two years of the program. As we previously reported, CMS indicated that it will allow non-eligible providers to participate in MIPS on a voluntary basis during the 2017 and 2018 reporting years. That’s good news for providers wanting to maintain continuity in their quality data-reporting habits. But, because CMS failed to address the details of voluntary MIPS participation in this year’s Final Rule, it’s hard to say—at this point—what, if any, incentives therapists will receive for their efforts. Be sure to keep an eye on the WebPT Blog for more MIPS-related news as it becomes available.

You’re still on the hook for any PQRS penalties in 2017 and 2018

Eligible providers (EPs) who didn’t meet PQRS requirements in 2015 or 2016 will still be held financially accountable in 2017 or 2018, respectively—despite the fact that the PQRS program as we know is no more come the stroke of midnight on New Year’s Day 2017. So, if you failed to report satisfactorily in 2016, you will incur a 2% downward payment adjustment on all Medicare Part B payments in 2018.

There you have it—in 2017, the US healthcare system will wave goodbye to PQRS and say hello to MIPS, the new boss on the payment system block. And while that means that therapists technically are off the hook for quality reporting for two years, we strongly recommend making an effort to stay in the habit of collecting this type of patient data. After all, you, too, want to be one of the cool kids—err, healthcare providers—who is seen as a first-choice provider across the entire healthcare spectrum.

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    downloadOct 3, 2019

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