The results of the 2016 year are in for the performance results for Value Modifiers, often shortened to just VM. Though this is the last year these performance results will affect reimbursement before the implementation of the Merit-based Incentive Payment Program (MIPS), the statistics are showing that a high number of practices will receive either neutral or even negative adjustments for 2018. With such a high number of practices missing out on a positive reimbursement adjustment, there’s a good chance that you will be affected.
For this year, only a minuscule 3,478 practices will receive an upward reimbursement adjustment, a number that represents just 1.7% of the total eligible practices. This figure is followed closely by the 3.9% of practices who will receive a neutral payment adjustment due to “holding harmless from performance.” From there, the statistics rise significantly. Those practices receiving a neutral reimbursement adjustment thanks to their performance make up 35.7%, while practices who will suffer a downward adjustment due to lack of performance count for a whopping 58.7% of the total.
If your practice was one of the few that satisfied the performance requirements and received an upward adjustment, then give yourself a pat on the back and keep up the good work. If, however, your practice earned a neutral or even a negative reimbursement adjustment, then it’s time to consider how to approach matters differently in 2018. With MIPS now in full swing, achieving a good reimbursement will be more difficult than ever, especially given that cost will now account for a 10% weight in this year’s equation. Although this may seem intimidating, remember that by far the easiest way to earn a negative reimbursement is to not report any performance data at all. By recording and submitting even a single quality measure, you can help protect your practice from future negative payment adjustments.