Avoid Payment Cut by Reporting Quality Data through STS National Database

STS News, Summer 2017 -- Cardiothoracic surgeons participating in the STS Adult Cardiac Surgery Database (ACSD) can avoid a Medicare penalty by reporting Quality measures to the Centers for Medicare & Medicaid Services (CMS) through the STS National Database.

The Merit-Based Incentive Payment System (MIPS) is a new CMS program that combines elements of existing Medicare physician quality programs, including the Physician Quality Reporting System, the Value Modifier, and the Electronic Health Record Incentive Program. Clinicians will be evaluated on four categories under MIPS, with the Quality category carrying the most weight.

Eligible professionals who do not satisfactorily report on at least one MIPS category during the January 1–December 31, 2017 reporting period will be subject to an automatic 4% negative payment adjustment in the 2019 Medicare Part B Fee Schedule.

ACSD participants can consent to have STS submit data on 14 different measures to CMS on their behalf, thus fulfilling the reporting requirement, avoiding the penalty, and potentially qualifying for a small to a moderate upward payment adjustment, depending on performance and the number of measures and activities reported under MIPS. A consent form must be submitted by Tuesday, October 31, 2017.

This service is free for STS members. Non-members participating in the ACSD will each be assessed a $500 fee for the Society to transmit data on their behalf.

Please note that STS will not report for surgeons who are enrolled in or part of an Accountable Care Organization or who plan to report in a group through the MIPS group reporting option known as GPRO. As a result, surgeons who are employed by hospitals or health systems are encouraged to check and see if other reporting arrangements have been made before submitting a MIPS consent form to STS.

Reporting Quality data is just one component of the MIPS program. To receive a bonus payment, clinicians can elect to report data in other MIPS categories, including Improvement Activities and Advancing Care Information.

If you have questions about MIPS Quality reporting, contact Derek Steck, STS National Database Coordinator, at Derek Steck or (312) 202-5818.


Access New MACRA Toolkit

MIPS falls under the umbrella of the Quality Payment Program, which was established by the Medicare Access and CHIP Reauthorization Act (MACRA). The Society has compiled a MACRA Toolkit for Cardiothoracic Surgeons that includes detailed overviews of both MIPS and Advanced Alternative Payment Models, a checklist of steps to take this year, and additional CMS resources. Access the MACRA toolkit.

2017 - MIPS Transitional Reporting Year

NO PARTICIPATION

• Submit nothing and receive
4% penalty in 2019

AVOID PENALTY

REPORT:
• 1 Quality Measure* OR
• 1 Improvement Activity* OR
• Required ACI Measures*

PARTIAL PARTICIPATION

REPORT:
• >1 Quality Measure AND/OR
• >1 Improvement Activity AND/OR
• “More than required” ACI

FULL PARTICIPATION

• Full Reporting Across All Categories
• Eligible for “Exceptional Performance”
Bonus Payment

*Must be for Medicare Part B patients