Merit-based Incentive Payment System (MIPS)

At the heart of the health care industry’s move to value-based care is the Merit-Based Incentive Payment System (MIPS). MIPS is currently the Centers for Medicare & Medicaid Services (CMS) largest value-based care payment program.  MIPS combined the previous existing quality and value reporting programs (Physician Quality Reporting System, Meaningful Use, and the Value-based Modifier) into one point based program with four performance categories: Quality, Cost, Improvement Activities and Promoting Interoperability (formally Advancing Care Information). Every year, performance in these categories are aggregated together into a final score (100-point based) used to determine an upward or downward payment adjustment for a MIPS-eligible clinician or group each payment year.

 
Now in its third year, the stakes are even higher and continue to grow through additional payment adjustments, based on performance. Every Medicare Part B Fee-for-Service (FFS) performed is impacted by MIPS. The scores you earned in Year 1, 2017, whether as a small incentive or full penalty, depending performance, are now reflected in the payment adjustments for 2019 services. For future years, if you do not report and are eligible you will be subject to penalties upward of 9%. Are you ready? Do you need help?

 

MIPS Payment Adjustments
Performance
Year
Medicare Part B
Payment
Adjustment Year
Maximum MIPS Penalty +/-
2017 2019 4%
2018 2020 5%
2019 2021 7%
2020 2022 9%
2021 2023 9%
2022 2024 9%
 
 
For Conventus Members, we offer expert guidance to help your practice transition from traditional fee-for-service to value-based care. We provide customized support to help your practice succeed in MIPS through:
  • On-site assessment of practice readiness and reporting opportunities
  • Workflow and process optimization
  • Strategic action planning with customized solutions for program success
  • Recommendations for participation options, measure selection and integration
 
To learn more about the MIPS Program read our 2019 Overview and Eligibility Summary.
 
 
Conventus Member Services
Do you have questions? Need information or support with MIPS?  As always, Conventus members can call our Practice Resource Department at (877)-444-0484  ext.7466 to speak with a member of our team for assistance with MIPS.
 
 
Disclaimer: The information contained herein is intended for educational purposes only. NIP Management Co., LLC/Conventus takes reasonable efforts to provide accurate information but cannot guarantee its accuracy or that it meets local, state, or federal statutes, laws, or regulations. NIP Management Co., LLC/Conventus disclaims any and all liability for reliance upon the information contained therein. It is suggested that you consult your legal counsel or other professional consultant(s) if you have any questions about how it pertains to your specific situation.