MIPS Streamlines Quality Reporting Categories

The Medicare Incentive Payment System (MIPS) consolidates current Medicare quality programs (Physician Quality Reporting System, EHR Meaningful Use, and Value-Based Payment Modifier) and adds a new category for Improvement Activities. MIPS also offers the first substantial rewards for achieving high-quality care.

MIPS reporting begins in January 2017, with payment adjustments starting in January 2019. Each “eligible clinician” or group will receive a “composite performance score” for performance in four categories—Quality, Cost, use of certified electronic health records under Advancing Care Information (ACI), and Improvement Activities—compared against the average of all MIPS clinicians. Those scoring above average receive a bonus, while those scoring below average receive a penalty. Scoring is somewhat flexible, but here are some general guidelines:

MIPS bonuses—and penalties—will be up to 4 percent in 2019, 5 percent in 2020, 7 percent in 2021, and 9 percent in 2022. Those payment adjustments are budget neutral. But there is an extra $500 million a year for bonuses of up to 10 percent for “exceptional” performers, from 2019 to 2024.■