CMS released the 2019 Quality Payment Program Final Rule on November 1, 2018.  Below are highlights of some of the key changes for Year 3 of the QPP MIPS program.  eMDs 2019 MIPS Report Guide will be released in January 2019.  

New eligible clinician types: Physical therapist, Occupational therapist, Qualified speech-language, pathologist, Qualified audiologist, Clinical psychologist, Registered dietitian or nutrition professionals 

MIPS Final Score Weighting:

  • Cost continues to be worth more when compared to the prior reporting year, now weighted as 15% of participant's MIPS final score. 
  • Quality has also been adjusted to be worth 45% for 2019 reporting. 
  • Promoting Interoperability (25%) 
  • Improvement Activities (15%) will remain the same weight as they were in 2018.
  • The performance thresholds for 2019 have become slightly more challenging:   
    • 0-29%: Below minimum performance threshold. Will result in a -7% penalty.
    • 30-74%: Acceptable performance. Penalty will be avoided, and up to a 7% incentive is possible.
    • 75%+: Exceptional performance. Penalty will be avoided, participants will be eligible for the 7% incentive + a possible extra 10% for exceptional performance

Quality Performance Category:  The basic requirements of the Quality performance category aren't changing much when compared with 2018 reporting. Participants still must report six quality measures, one of which is an outcome measure. If no outcome measures apply, a high-priority measure may be used in its place. It is important to review the 2019 measures and measure sets as there are new measures and many measures were removed.    


Cost Performance Category:  Cost measure performance is captured automatically via administrative claims, so no additional submission is required. The two measures that are being utilized to determine participants 2018 Cost score, total per capita cost and Medicare spending per beneficiary, will continue to be used in 2019. Additionally, eight episode-based measures will be introduced


Improvement Activities Performance Category:  There are 6 new improvement activities available for attestation in 2019 - Comprehensive Eye Exams (Medium), Financial Navigation Program (Medium), Completion of Collaborative Care Management Training Program (Medium), Relationship-Centered Communication (Medium), Patient Medication Risk Education (High), Patient Safety and Practice Assessment (High).  Additionally, 1 activity has been retired: Participation in Population Health Research.


Promoting Interoperability Performance Category:  The most impactful change that has been finalized for 2019 is the requirement to use 2015 Edition CEHRT. The objectives and measures finalized for 2019 are in this table from the Final Rule:

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