INNOVATIVE THINKING
RIGOROUS APPROACHES
REAL WORLD IMPACT

 

Project

QPP Merit-based Incentive Payment System Customer and Program Support Services

Official Title
Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) Customer and Program Support Services
Location(s)
United States
Dates
9/2017–8/2022
Market
IMPAQ Health
Services
Policy/Program Analysis
Technical Assistance
Client
Centers for Medicare & Medicaid Services (CMS)
Methodologies
Education and Outreach
Human-Centered Design
Scaled Agile Framework

Since 2017, IMPAQ has worked with the Centers for Medicare & Medicaid Services (CMS) to make the shift to value-based care—a system that rewards providers for health care outcomes and quality rather than volume. This shift is implemented through the Merit-based Incentive Payment System (MIPS), which consolidates three previous quality reporting programs: the Value-based Payment Modifier (VM), the Physician Quality Reporting System (PQRS), and the Electronic Health Record Incentive Program – Meaningful Use (MU).

The purpose of MIPS is to financially reward Medicare clinicians for providing high-value, patient-centric health care, while reducing the reporting burden for clinicians. In implementing MIPS, CMS needs the following support:

  • Agile health policy expertise to translate program policy into actionable steps for participating clinicians.
  • IT product and health informatics expertise to implement and improve program reporting and feedback systems.
  • User-focused, knowledgeable customer support to help clinicians and stakeholders navigate and successfully participate in the program.

Impact

Through our support, IMPAQ has helped CMS achieve high clinician participation and performance in the MIPS program, including among clinicians from small, underserved, and rural areas who have historically faced limitations in successfully participating in CMS’ quality reporting programs. This success has significant impact on the quality and value of health care for millions of Americans, as CMS rewards providers for outcomes and quality of care rather than volume.

Methodology

To help successfully implement MIPS, IMPAQ leads education and outreach efforts on behalf of CMS. This includes translating MIPS policy into actionable content and resources that help clinicians understand program requirements so they can successfully participate in the program. We coordinate across contractors and stakeholders to communicate program milestones and requirements to providers through various mediums including fact sheets, user guides, web content, and informational videos.

To provide user-centered customer service to those engaging in the MIPS program, IMPAQ operates a level-two customer service center. We provide technical assistance and support to clinicians, clinician representatives, vendors, and other stakeholders on an array of program topics, including eligibility, performance category measures and activities, reporting policy and systems, scoring and payment adjustments, and performance feedback.    

IMPAQ is implementing a Scaled Agile Framework (SAF) to work across numerous contractors required to fully execute a new quality payment incentive program. We also work closely with CMS, participating clinicians, and stakeholders to discover how we can continuously improve aspects of MIPS for users by incorporating human-centered design (HCD) concepts.

Our improvement efforts have helped to:

  • Demystify MIPS program eligibility for clinicians.
  • Improve cross-contractor communications about policy updates and emergent issues.
  • Enhance onboarding of newly eligible clinicians and improve tailored service center support for all participants.

Experience & Expertise

The IMPAQ team has vast experience managing numerous large CMS contracts that require complex, cross-contract coordination. On this project, the team consists of senior researchers, health informaticists, and policy experts. Together with our partner, Telligen, we bring an extensive and diverse array of skills necessary to meet the needs of CMS, clinicians, and stakeholders.