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PROPOSED 2018 MIPS and APM changes

On June 20, 2017, the Centers for Medicare & Medicaid Services (CMS) released the PROPOSED RULE for the 2018 Quality Payment Program, which includes the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements.

The Medicare Access and CHIP Re-authorization Act of 2015 (MACRA) requires that the Quality Payment Program is reevaluated and updated annually.

The proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018.

Highlights of the proposed rule include:

  • Creating 2018 MIPS reporting requirements
  • Delaying the previously-finalized 2018 requirement to upgrade 2014 Certified EHR Technology to the 2015 edition
  • Increasing the low-volume threshold
  • Delaying implementation of the Cost component of MIPS (which was set at 10% of the total MIPS score for 2018)
  • Incorporating the option to use facility-based scoring for facility-based clinicians
  • Offering the virtual group option for solo and small practices to aggregate their data for a shared MIPS evaluation
  • Outlining criteria for qualification as a participant in an all-payer APM, beginning in 2019


To review a fact sheet on the proposed rule, please visit:

The proposed rule (CMS-5522-P) can be downloaded from the Federal Register at:

CMS will be accepting public comments on the proposed rule until Aug. 21, 2017.

For more information about the 2017 Quality Payment Program, please visit: