Merit-based Incentive Payment System (MIPS)

Merit-based Incentive Payment System (MIPS) is one of two participation tracks under the QPP program and is a suitable option for many eligible clinicians who are starting to shift away from fee-for-service and aren’t ready to bear financial risks as required under the Advanced APM participation track.  Under MIPS, qualifying participants are rewarded based on performance in four categories:

    • Quality
    • Promoting Interoperability (formerly Advancing Care Information)
    • Improvement Activities, and
    • Cost

Each of the categories has its own set of measures, requirements, scoring and submission options.  Performance scores are combined across the categories is reported to Medicare annually.  These scores are used to determine Medicare reimbursements for qualified clinicians.  The more points you earn, the better your score, and the higher your potential for a positive adjustment in 2020.  

Don’t think your scores matter?  CMS disagrees.  Medicare will publicly post your MIPS score on Physician Compare to offer patients insight into the quality and value of care reported. 

MIPS scoring can be complex.