HSAG engages providers at all levels of performance for collaborative learning and action that accelerate healthcare quality improvement. Use the resources below to better understand and successfully implement the Quality Payment Program (QPP).
Merit-based Incentive Payment System (MIPS) Overview
- 2021 MIPS Overview (newly published)
- 2021 MIPS Eligibility Decision Tree
- 2020 MIPS Overview
- 2020 MIPS FAQs
- Comparison of MIPS Year 4 (2020) and Year 5 (2021) Requirements (newly published)
- Comparison of MIPS Year 3 (2019) and Year 4 (2020) Requirements
- Impact of MIPS Participation on Medicare Reimbursements
- No-EHR MIPS Action Plan (newly published)
- 2021 Quality Payment Program Final Rule FAQs
Facility-based Reporting
Participation in MIPS
HSAG encourages your use of the following resources to help guide your understanding of PI (formerly known as ACI).
- 2021 Promoting Interoperability Measure Specifications (ZIP)
- 2020 Promoting Interoperability Quick Start Guide
- 2020 Promoting Interoperability Measure Specifications (ZIP)
- Security and Risk Assessment Webinar (February 22, 2019)
- Provider EHR Complaint Process
- Patient Engagement Playbook from the Office of the National Coordinator (ONC)
- How to Get Your Patients to Use the Patient Portal webpage from p3Inbound
- Anti-Ransomware Resources
HSAG has assembled helpful IA-based resources and tools to assist you.
- 2021 Improvement Activities Inventory (ZIP)
- 2020 IA Quick Start Guide
- 2020 MIPS Alternative Payment Models (APMs) Improvement Activities
- Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Center—Obtain PDMP-related information, including where to find your PDMP by state.
- Improvement Activities Related to PDMP
- High-Priority IA: Consultation of the PDMP—Clinicians would attest to reviewing the patients' history of controlled substance prescription using state PDMP data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient's history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient's history performance.
- PDMP information for Arizona
- PDMP information for California
- PDMP information for Florida
- PDMP information for Hawaii
- PDMP information for New Mexico
From time to time, resources are from CMS and are updated and posted regularly as new updates come online.
QPP and Merit-based Incentive Payment System (MIPS)
- What is the Quality Payment Program? (2:30)
- How to Access Performance Feedback for Individuals —2018 (9:00)
- How to Access Performance Feedback for Voluntary Submitters —2018 (3:45)
APMs
- MIPS APMs (Online course from Medicare Learning Network, offering .5 AMA PRA Category 1 Credits)
- What are the criteria for APMs? (13:00)
- What is a Qualifying APM Participant? (13:45)
- How to Access Performance Feedback for APM Entities —2018 (7:00)
Creating a HARP Account for QPP
(HARP = Healthcare Quality Information System [HCQIS] Access Roles and Profile)
HSAG has gathered relevant QPP materials and tools into one place. In addition, download a handy graphic icon for conversion into a desktop widget by following easy step-by-step instructions. To get started, review these essential tools for your state:
MIPS Data Validation and Audit Resources
The Centers for Medicare & Medicaid Services (CMS) has contracted with Guidehouse to conduct data validation and audits of a select number of Merit-based Incentive Payment System (MIPS) eligible clinicians. If you are selected for data validation and/or audit, you will receive a request for information from Guidehouse. It will be sent via email or by certified mail. Please be on the lookout for this notification. You will have 45 calendar days from the date of the notice to provide the requested information. Please note, if you do not provide the requested information CMS may take further action, to include the possibility that you will be selected for future audits. The following data validation and audit resources available to support clinicians selected to participate.
- 2021 QPP Documents for an Audit (PDF) (newly published)
- 2020 QPP Documents for an Audit (PDF)
- 2020 MIPS Data Validation Criteria (ZIP)
- 2019 MIPS Data Validation Criteria (ZIP)
- 2018 MIPS Data Validation Criteria (ZIP)
- 2017 MIPS Data Validation Criteria (ZIP)
- MIPS Data Validation and Audit Factsheet PY 2017 & 2018
Other Helpful Resources
The Centers for Medicare & Medicaid Services (CMS) have assembled QPP-related resources at https://qpp.cms.gov/about/resource-library.
Be sure to visit these CMS resources:
- 2021 Qualified Registries Qualified Posting (XLSX)
- 2021 Qualified Clinical Data Registry (QCDR) Measure Specifications (XLSX)
- Quality Payment Program COVID-19 Response
- Update Provider Enrollment, Chain, and Ownership System (PECOS)
- 2020 QCDRs Qualified Posting (XLSX)
- 2020 Qualified Registries Qualified Posting (XLSX)
- 2020 Registration Guide for the CMS Web Interface and CAHPS® for MIPS Survey
* CAHPS® = Consumer Assessment of Healthcare Providers and Systems®
Alternative Payment Models (APMs)
- 2021 APM Performance Pathway (APP) for MIPS APM Participants
- 2021 APM Performance Pathway (APP) Infographic
- 2021 Qualifying APM Participant (QP) Quick Start Guide
- APMs in QPP
- 2020 SSP and QPP Interactions Guide
MIPS Value Pathways (MVPs)
CMS have finalized the MIPS Value Pathways (MVPs), a participation framework that would begin with the 2022 performance period. Review the information below to learn more about the MVPs framework, and how it will help to improve the Merit-based Incentive Payment System (MIPS) and make the program more meaningful to clinicians and patients.
