Interested in joining a virtual group? Your practice has until Dec. 1st

October 31, 2017

Leona Rajaee

Interested in joining a virtual group? Your practice has until Dec. 1st October 31, 2017

Independent physicians who want to participate in the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)’s Merit-based Incentive Payment Systems (MIPS) may find that their Medicare patient and billing volume is too low to qualify them for the program.

MIPS moves providers away from the typical fee-for-service model to a performance-based payment system. However, smaller practices may not meet the minimum requirements of “billing more than $30,000 a year AND providing care for more than 100 Medicare patients a year.”

CMS has recognized the challenges faced by independent physicians and now offers the option of joining a virtual group of “solo practitioners and small practices that join together to report on MIPS requirements as a collective entity.” These virtual groups are to be comprised of ten or fewer eligible practitioners with a combination of Tax Identification Numbers (TINs).

To be eligible for 2018 participation in MIPS as a virtual group, practices must join a group that must send its information to CMS by December 1, 2017. According to the American Academy of Family Physicians (AAFP), there are two stages for practices that opt to participate in a virtual group:

Stage 1: Solo practitioners and groups with 10 or fewer eligible clinicians may contact their designated Technical Assistance representative(qpp.cms.gov) or the Quality Payment Program Service Center to determine if they are eligible to join or form a virtual group.
Stage 2: CMS will determine if the group members are eligible to join or form a virtual group. During Stage 2, the virtual group must name an official representative who will submit their election to CMS via email to MIPS_VirtualGroups@cms.hhs.gov by Dec. 1.

Elation Health is preparing to offer functionality to these providers that will allow them to dynamically collaborate on patient charts – a key driver of success in the new MACRA reimbursement system. Virtual group participation should improve the quality of care received by patients of the participating providers by facilitating care coordination and improvement activities.