CMS Releases 2021 Quality Payment Program (QPP) Experience Report

CMS recently released its most recent QPP Experience Report, reflecting data on clinician eligibility, participation, and performance related to the 2021 performance year of the Merit-Based Incentive Payment System (MIPS) and Qualifying Advanced Payment Model Participants (QPs). An accompanying QPP Public Use File (PUF) includes more detailed information related to individual clinicians who received a 2021 MIPS final score.

Key findings from 2021 include:

• 94% of MIPS eligible clinicians engaged (i.e., submitted data for one or more performance categories) in the program.
• 86% of MIPS eligible clinicians received a positive payment adjustment in 2021 despite the minimum score for a positive payment adjustment increasing from 45 to 60 points.
• 78% of MIPS eligible clinicians received a positive adjustment, as well as an additional adjustment for exceptional performance, with the maximum positive payment adjustment for 2023 being 2.34% based on 2021 performance.
• 11% of MIPS eligible clinicians received a neutral adjustment and only 3% received a penalty.
• MIPS eligible clinicians receiving a final score from their APM Entity continued to earn the highest mean final score (97.48 points) in 2021, followed by groups (88.32 points), virtual groups (86.89 points), and individuals (71.61 points).
• The mean final score for MIPS eligible clinicians participating as individuals rose from 64.66 in 2020 to 71.61 in 2021.
• The number of QPs rose from 235,225 clinicians in 2020 to 271,231 in 2021.
• The average final score for small practices increased from the first year of the program, from 43.16 in 2017 to 73.71 in 2021, while the average final score for rural clinicians went from 63.08 in 2017 to 88.44 in 2021.

More detailed information about these data can be found at the following links:

• 2021 QPP Participation Results Infographic
• 2021 QPP Experience Report Public Use File (PUF) Methodology
• 2021 QPP Experience Report PUF Data Dictionary