Pop Quiz: Test Your Assumptions About QPP 2019 Payment Year

QPP pop quiz!

Understanding the Medicare Quality Payment Program (QPP) is tough. But the data Medicare released from the 2017 performance year shows you were up for the challenge. And that’s good news because the 2017 performance year affects 2019 Medicare payments and maybe has helped you prepare for the 2019 performance year, too. Let’s see how you do on a quick quiz about the 2017 QPP performance year.

Ready, Set, Go … to the QPP Questions

Q1: Which number reflects the percentage of MIPS eligible clinicians receiving a positive adjustment AND an adjustment for exceptional performance?

  • A. 2 percent
  • B. 5 percent
  • C. 22 percent
  • D. 71 percent

Q2: Is 19 percent the percentage of rural practices or small practices receiving a negative payment adjustment?

Q3: Which submitter type had higher mean and median final scores: individuals (single TIN/NPI) OR groups (two or more NPIs billing with a single TIN or as an APM entity)?

Check Your Answers Here

A1: D. All you optimists got it right. Medicare reports that 71 percent of MIPS eligible clinicians earned a positive adjustment and an adjustment for exceptional performance for the 2017 QPP performance year. A positive payment adjustment only (still good news) is coming to 22 percent. That’s 93 percent expecting some sort of positive adjustment. Two percent will see no increase or decrease (neutral adjustment), and five percent will receive a negative payment adjustment.

A2: Nineteen percent is the number for small practices. Rural practices calculate to 6 percent receiving a negative payment adjustment.

To help small practices in the 2019 performance year, Medicare is continuing many of its past initiatives, such as keeping the small practice bonus (and moving it to the Quality performance category), allowing small practices to use Part B claims submission for Quality reporting, and the option to participate in MIPS as a virtual group. You also can keep an eye out for 2019 updates to the QPP page for small, underserved, and rural practices.

A3: Groups had both higher mean and median final scores than individuals. The mean (or average) is the sum of all final scores divided by the count of final scores by unique TIN/NPI. The median is different, showing the midpoint in distribution of final scores. So basically if you line up the scores from small to large, the median is in the middle.

The point here is that groups had the higher final scores:

  • Mean
    • Individuals: 55.08 points
    • Groups: 76.2 points
  • Median
    • Individuals: 60.00 points
    • Groups: 91.04 points.

Source: The information in the quiz is based on the QPP 2017 snapshot posted by Medicare.

What About You?

How did you do on the quiz? Were your assumptions (and knowledge) about the QPP results correct? Have you determined whether you’ll be seeing positive, neutral, or negative payment adjustments? What have you learned in the past two years of the QPP that will help you this coming year?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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