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Centers for Medicare & Medicaid Services Quality Payment Program. Small Practices Newsletter
Quality Payment Program Small Practices Newsletter: May 2024

The Quality Payment Program (QPP) Small Practices Newsletter is a monthly resource that provides small practices (15 or fewer clinicians) with program updates, upcoming QPP milestones, and resources to support their continued participation and success in QPP. We send this newsletter on the second Tuesday of each month.

Please share this newsletter with your fellow clinicians and practice staff and encourage them to sign up [ https://public.govdelivery.com/accounts/USCMS/subscriber/new?topic_id=USCMS_12879%2F&utm_source=newsletter&utm_medium=email&utm_id=newsletter_february2024&utm_content=smallpracsignup ] to receive this monthly resource.

*At-a-Glance: Required and Recommended Activities for Successful Participation in QPP *

Each month, we share required and recommended activities for small practices to support their successful participation in QPP. The activities follow a rolling quarter approach, letting you see activities for the previous month, the current month, and the following month.

May 2024 Small Practice Graphic

*In This Issue:                                                                                 *


* *Hot Topics: What You Need to Know*
* 2024 Quality Payment Program (QPP) Exception Applications are Available Now [ #link_1 ]
* 2022 Performance Year QPP Participation and Performance Data Released [ #link_2 ]
* 2024 MIPS Value Pathways (MVPs) Registration Now Open [ #link_3 ]
* 2024 CAHPS for MIPS Survey Registration Now Open [ #link_4 ]
* Relevant Small Practice Resources [ #link_5 ]

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2024 Quality Payment Program (QPP) Exception Applications are Available Now

The 2024 QPP Exception applications are available now through *December 31, 2024, at 8 p.m. ET*. There are 2 types of exception applications that allow users to indicate the reason they’re unable to report data for one or more Merit-based Incentive Payment System (MIPS) performance categories.

*MIPS Promoting Interoperability Performance Category Hardship Exception Application*

Individual clinicians, groups, and virtual groups (or a third party representative) can submit a MIPS Promoting Interoperability Performance Category Hardship Exception application for the following reasons:


* You have decertified Electronic Health Record (EHR) technology (must be decertified under the Office of the National Coordinator for Health Information Technology’s (ONC) Health IT Certification Program).
* You have insufficient internet connectivity.
* You face extreme and uncontrollable circumstances such as a disaster, practice closure, severe financial distress, or vendor issues.
* You lack control over the availability of certified EHR technology (CEHRT).

This application is specific to the MIPS Promoting Interoperability performance category. If your application is approved, you won’t be required to report data for this performance category.

*MIPS Extreme and Uncontrollable Circumstances Exception Application*

Individual clinicians, groups, and virtual groups (or a third party representative) can submit a MIPS Extreme and Uncontrollable Circumstances (EUC) Exception application for one or more MIPS performance categories (quality, cost, improvement activities, and Promoting Interoperability) due to extreme and uncontrollable circumstances, defined as rare events entirely outside of your control and the control of the facility in which you practice.

These circumstances would:


* Cause you to be unable to collect information necessary to submit for a MIPS performance category.
* Cause you to be unable to submit information that would be used to score a MIPS performance category for an extended period of time (for example, if you were unable to collect data for the quality performance category for 3 months).
* Impact your normal processes, affecting your performance on cost measures and other administrative claims measures.

Alternative Payment Model (APM) Entities can submit applications as well, but they must apply for all performance categories.

If your application is approved, you won’t be required to report data for the performance category or categories included in your approved application. However, please note that data submission overrides approved reweighting on a category-by-category basis. We’ll score any data that you—or someone on your behalf—submits, and those performance categories will contribute to your final score.

*How to Apply*

To submit either Exception application:


* Sign in to the QPP website [ https://qpp.cms.gov/login ] with your Health Care Quality Information Systems (HCQIS) Access Roles and Profile (HARP) account.
* Choose “Exceptions Application” from the left-hand navigation.
* Click “Add New QPP Exception” on the right side of the screen.
* Choose your exception type.

*Additional Resources*


* Quality Payment Program Access User Guide (ZIP, 3MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip ] – Refer to “STEP 1: Register for a HARP Account”
* QPP Exception Applications (webpage on the QPP website) [ https://qpp.cms.gov/mips/exception-applications?py=2024 ]__
* 2024 MIPS Promoting Interoperability Hardship Exception Application Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2846/2024-MIPS-PI-Hardship-Exception-Application-Guide.pdf ]__
* 2024 MIPS Extreme and Uncontrollable Circumstances Exception Application Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2845/2024-MIPS-EUC-Exception-Application-Guide.pdf ]__

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2022 Performance Year QPP Participation and Performance Data Released

The Centers for Medicare & Medicaid Services (CMS) released participation and performance data for the 2022 QPP performance year, including both MIPS and APM participation. The following resources are available now:


* The *2022 QPP Participation and Performance Results At-a-Glance (PDF, 462KB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2816/QPP-2022-Participation-and-Performance-Results-At-A-Glance.pdf ] provides a snapshot of aggregated data for key QPP program metrics, including a high-level overview of participation, scoring, and payment adjustment information.
* The_ _*2022 QPP Experience Report (PDF, 3MB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2817/2022ExperienceReport.pdf ] provides a more in-depth review of aggregated data on QPP program experience and review of program trends over time. The report includes an expansive set of aggregated program metrics on participation, performance category scoring, final scores, and payment adjustments factors.
* The *2022 QPP Public Use File* [ https://data.cms.gov/quality-of-care/quality-payment-program-experience/data/2022 ] includes clinician-level data at the Taxpayer Identification Number (TIN)/National Provider Identifier (NPI) level regarding clinician eligibility, measure level scoring, performance category scoring, final scores, and payment adjustments factors.

*Data Highlights*

Highlights of the QPP Participation and Performance Results At-a-Glance and Experience Report include:


* The total number of MIPS eligible clinicians receiving a payment adjustment, including the number and percentage of non-reporting clinicians.
* The mean and median 2022 MIPS final scores, as well as the mean and median unweighted scores for each performance category.
* The maximum MIPS payment adjustment amount (paid to clinicians with a final score of 100 points).
* The total number of Qualifying APM Participants (QPs).

*Additional Resources *

To learn more about the 2022 QPP Data Resources listed above, you can review the following supporting documentation:


* *2022 QPP Data Use Guide (PDF, 746KB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2674/2022DataUseGuide.pdf ]__
* *2022 QPP Experience Report Public Use File Methodology (PDF, 421KB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2820/2022-QPP-PUF-Methodology.pdf ]__
* *2022 QPP Experience Report Public Use File: Data Dictionary (PDF, 492KB)* [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2819/2022-QPP-PUF-Data-Dictionary.pdf ]

You can also find all of the QPP Data Resources from 2022 and prior years on the new Participation and Performance Data page [ https://qpp.cms.gov/resources/performance-data#public-data-files-2022 ] of the QPP website.

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2024 MIPS Value Pathways (MVPs) Registration Now Open

The MVPs registration window is open for the 2024 performance year. Individuals, groups, subgroups, and APM Entities that want to report an MVP can register *until December 2, 2024, at 8 p.m. ET*.

*Note: If the Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey is an available measure in your selected MVP and you want to administer it as 1 of your 4 required measures, you‘ll need to complete both your MVP registration and a separate CAHPS for MIPS Survey registration by *July 1, 2024, at 8 p.m. ET*.

*NEW FOR 2024: *To register, you’ll sign in to the QPP website [ https://qpp.cms.gov/ ]with your HARP account [ https://qtso.cms.gov/access-forms/harp-account-registration ]. This is different from the 2023 process of completing an Excel form and emailing the QPP Service Center.

You must have a HARP account and a QPP Security Official role to complete the MVP registration.


* For more information on HARP accounts, please refer to the STEP 1. Register for a HARP Account document in the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip ].
* For more information on obtaining the QPP Security Official role, review the Step 2a. Connect to an Organization document in the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip ].

*Prepare for MVP Registration*

To help you prepare for MVP registration, please refer to the 2024 MVPs Implementation Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2778/2024-MVPs-Implementation-Guide.pdf ] and the 2024 MVPs Registration Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2750/2024MVPRegistrationGuide.pdf ].

Visit the Explore MVPs [ https://qpp.cms.gov/mips/explore-mips-value-pathways?py=2024 ] page to learn more about the available MVPs for the 2024 performance period.

*How to Register*

Individuals, groups, subgroups, and APM Entities will register on the QPP website. You'll need to have the Security Official role to register your organization. Please refer to the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip ] for information about obtaining a Security Official role for your organization. To register:


* Sign in to QPP [ https://qpp.cms.gov/login ].
* Click *Register or Edit an MVP Registration* from the landing page.
* Click your MVP reporting option.

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2024 CAHPS for MIPS Survey Registration Now Open

Registration is open through *July 1, 2024, at 8 p.m. ET* for the CAHPS for MIPS Survey [ https://www.cms.gov/data-research/research/consumer-assessment-healthcare-providers-systems/cahps-mips ] for the 2024 performance year.

Groups, virtual groups, subgroups, and APM Entities with 2 or more clinicians (including at least one MIPS eligible clinician) can register to administer the CAHPS for MIPS Survey [ https://www.cms.gov/data-research/research/consumer-assessment-healthcare-providers-systems/cahps-mips ] for traditional MIPS [ https://qpp.cms.gov/mips/quality-requirements?py=2024 ], APM Performance Pathway (APP) [ https://qpp.cms.gov/mips/app-quality-requirements?py=2024 ], or MVPs [ https://qpp.cms.gov/mips/mips-value-pathways ] reporting.

*Who doesn’t need to register?*


* Medicare Shared Savings Program Accountable Care Organizations (ACOs) [ https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/about ]
* These ACOs are required to report through the APP so they’re automatically registered for the CAHPS for MIPS Survey, which is required under the APP.

* These ACOs don’t need to register but will still need to hire a CMS-approved vendor to administer the CAHPS for MIPS Survey.

*Who must register?*


* Groups and APM Entities (other than Shared Savings Program ACOs) that choose to report through the APP must register because the *CAHPS for MIPS Survey is a required measure under the APP*.

*Who can register?*


* Groups, virtual groups, and APM Entities that intend to administer the CAHPS for MIPS Survey as 1 of their 6 quality measures for reporting traditional MIPS.
* Groups, subgroups, and APM Entities that are registered to report the following MVPs [ https://qpp.cms.gov/mips/explore-mips-value-pathways?py=2024 ] and that intend to administer the CAHPS for MIPS Survey as 1 of their 4 quality measures:
* Adopting Best Practices and Promoting Patient Safety within Emergency Medicine MVP [ https://qpp.cms.gov/mips/explore-mips-value-pathways/2024/G0057 ]
* Advancing Cancer Care MVP [ https://qpp.cms.gov/mips/explore-mips-value-pathways/2024/M0001 ]
* Value in Primary Care MVP [ https://qpp.cms.gov/mips/explore-mips-value-pathways/2024/M0005 ]

*How to Register*

Groups, virtual groups, and APM Entities will register on the QPP website [ https://qpp.cms.gov/ ]. You'll need to have the Security Official role to register your organization. Please refer to the QPP Access User Guide (ZIP, 4MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/335/QPP%20Access%20User%20Guide.zip ] for information about obtaining a Security Official role for your organization. To register:


* Sign in to QPP [ https://qpp.cms.gov/login ].
* Click *Start Registration* from the landing page.
* Click *Register or Edit CAHPS Registration*.

You *must register by 8 p.m. ET on July 1, 2024*.

*Additional Resources*


* 2024 CAHPS for MIPS Survey Registration Guide (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2781/2024-CAHPS-Registration-Guide.pdf ]

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Relevant Small Practice Resources

*2024 Small Practice Resources*

2024 What’s New for Small Practices (PDF, 787KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2657/2024What%27sNewforSmallPractices.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=february+2024&utm_id=newsletter_february2024&utm_content=24whatsnewsp ]

2024 MIPS Quick Start Guide for Small Practices (PDF, 1MB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2622/2024MIPSGuideforSmallPractices.pdf?utm_source=newsletter&utm_medium=email&utm_campaign=february+2024&utm_id=newsletter_february2024&utm_content=24mipsguidesp ]

MIPS 2024 Small Practice Eligibility and Participation FAQs (PDF, 461KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2729/2024-Small-Practice-Eligibility-FAQs.pdf ]

Do I Need to Participate in MIPS? How to Check Eligibility Status (VIDEO) [ https://www.youtube.com/watch?v=rHoH4hJaetI ]

Small Practices FAQs [ https://qpp.cms.gov/resources/small-underserved-rural-practices#:~:text=Service%20Center%20Ticket-,FAQs,-Am%20I%20eligible ]

QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


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