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Quality Payment Program

TMF Health Quality Institute helps clinicians successfully participate in the Quality Payment Program (QPP), the Medicare payment program that replaces fee-for-service reimbursement with a value-based approach that promotes efficient, patient-centered care.

TMF provides individualized support for all aspects of the QPP and the Merit-based Incentive Payment System (MIPS), one of the two QPP payment tracks. The Centers for Medicare & Medicaid Services (CMS) has contracted with TMF to provide QPP assistance to clinicians in small (15 or fewer clinicians) and rural practices in Arkansas, Colorado, Kansas, Louisiana, Mississippi, Missouri, Oklahoma, Puerto Rico and Texas.

Upcoming Events

Check out educational events, workshops and office hour webinars from TMF and other relevant sources.

TMF MIPS Toolbox

The Toolbox is a free online application to help clinicians organize and monitor their MIPS participation.

CMS QPP Website

Check your MIPS eligibility, review category requirements, access resources and log in to your QPP Portal.

Announcements
New Resources

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CMS News: New 2020 Events Added to Automatic Extreme and Uncontrollable Circumstances for MIPS

In response to the Federal Emergency Management Agency (FEMA) designation of Hurricane Laura as a national disaster, the Centers for Medicare & Medicaid Services (CMS) has determined that the automatic extreme and uncontrollable circumstances policy will be applied to Merit-based Incentive Payment System (MIPS) eligible clinicians in FEMA-identified areas in Louisiana.

CMS Will Retire the Original Compare Tools Dec. 1

In September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov. The eight original compare tools – like Nursing Home Compare, Hospital Compare, Physician Compare – will be retired Dec. 1, 2020, ending this transition period.

CMS News: QP Thresholds Are Increasing in 2021; You May Need to Participate in MIPS Next Year

Qualifying Alternative Payment Model (APM) Participant (QP) thresholds are increasing beginning Jan. 1, 2021. If you were a QP for the 2020 performance year, you may not necessarily receive QP status for the 2021 performance year. Depending on your status in 2021, you may be required to participate in the Merit-based Incentive Payment System (MIPS) even if you haven’t in previous years. This PDF answers your questions.

CMS News: 2021 MIPS Eligibility Decision Tree

This PDF from the Centers for Medicare & Medicaid Services (CMS) helps clinicians determine if they are eligible to participate in the Merit-based Incentive Payment System (MIPS) track of the Quality Payment Program (QPP) in the 2021 performance period.

CMS News: 2019 QPP Participation Results

This infographic (PDF) shows 2019 participation data and 2021 payment adjustment data for the Quality Payment Program (QPP).

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These items also available in the Resource Library

Let's Talk QPP! Year-end Checklist: Prepare to Report for 2020

The Merit-based Incentive Payment System (MIPS) has been challenging this year! There are many options to reporting for 2020, including exceptions, exclusions, identifying new quality measures and more. In this session, TMF consultants walk you through a checklist on preparing to report for 2020 once the ball drops on 2021.

Security Risk Analysis Fact Sheet

This PDF explains the Security Risk Analysis (SRA), which is a requirement for the Promoting Interoperability (PI) category of the Merit-based Incentive Payment System (MIPS), as well as the HIPAA Security Rule.

Updating Your National Plan & Provider Enumeration System (NPPES) Account

The Centers for Medicare & Medicaid Services uses the National Plan & Provider Enumeration System, or NPPES, to manage provider information and identifiers. It is important that clinicians and practices keep this system up to date with accurate provider information. This video demonstrates how to make basic updates.

Updating Your Medicare Provider Enrollment, Chain, and Ownership System (PECOS) Account

The Medicare Provider Enrollment, Chain, and Ownership System, or PECOS, is a database of Medicare-enrolled providers and suppliers. It is important that providers keep this system updated with any changes in provider information. This video demonstrates how to make edits to provider information in PECOS.

Let's Talk QPP! How to Complete an Exception Application in the QPP Portal

In 2020, both the Promoting Interoperability exception and the Extreme and Uncontrollable Circumstances exception must be completed in the Quality Payment Program (QPP) Portal. In this webinar, TMF consultants walk participants through these processes, including how to withdraw an application if the clinician prefers to report after their application has been completed.

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Quality Payment Program

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