Quality Payment Program Performance Year 2019

For the 2019 performance year, QPP made some enhancements to the Merit-based Incentive Payment System (MIPS) participation and eligibility for clinicians by adding new provider types under the Advanced Alternative Payment Models (APM): Physical Therapist, Occupational Therapist, Speech-Language Pathologists, Audiologists, Clinical Psychologist, and Registered Dietitians or Nutritional Professionals.

For those clinicians who participate in an APM and achieve certain thresholds, they are eligible for Qualified Participant (QP) or Partial Qualified Participant (PQ) status which would exempt them from MIPS reporting. Participation in OneCare’s Vermont Medicare ACO Initiative Program does not automatically exempt a participant from MIPS reporting. Should an eligible clinician achieve QP status under an Advanced Alternative Model, they would be eligible for a 5% incentive payment beginning in 2021.

To view your QP or PQ status, we recommend that all OneCare participants continue to confirm their status by using the look-up tool to determine whether they may or may not need to report MIPS. To find out if an individual clinician has achieved QP or PQ status, please use this link.

As a reminder for those providers who are not affiliated with a hospital, independent primary care practice, or FQHC, you may be designated as a preferred provider for the 2019 performance year and will be required to report in all four performance categories for MIPS; Quality, Cost, Performing Interoperability, and Improvement Activities. In addition to reporting for all four performance categories under MIPS, you will need to attest to Certified Electronic Health Record Technology (CEHRT) that meets the 2015 Edition Base EHR definition and has been certified to the 2015 Edition health IT certification criteria.

For questions about MIPS participation or the QPP program, please contact Shawntel Burke at 802-847-8495 or email Shawntel.burke@onecarevt.org.