MIPS Reporting (Merit-Based Incentive Payment System)
MIPS has streamlined the existing quality Medicare reporting programs, such as the Value-Based Payment Modifier (VM), Medicare EHR Incentive Program (MU), and Physician Quality Reporting Program (PQRS). Initially, most clinicians qualified for MIPS reporting in its inaugural year, 2017. However, over time, CMS has introduced eligibility rules and performance parameters to enhance quality care and reward satisfaction.
The Era of Quality Care Begins with Value-Based Incentive Payment Programs
Many clinicians face the complexities of the healthcare system, but technology integration empowers them with advanced procedures while facilitating patient care. MIPS aims to create financial opportunities for clinicians, acknowledging the need for such procedures.
Does MIPS Reporting Truly Reflect Your Efforts to CMS?
Through the Medicare incentive payment program (MIPS), physicians can earn positive payment adjustments for their quality-based endeavors. CMS indeed rewards physicians for exceptional performance in the following categories:
Quality (Previously PQRs)
Improvement Activities (IA)
Promoting Interoperability (PI)
Cost (Previously VBM)
Who Is Eligible to Participate in MIPS?
To be eligible for MIPS data submission, you must:
Offer professional healthcare services to more than 200 Medicare beneficiaries
Provide over 200 covered professional services to Part B patients
Bill more than $90,000 per year for covered professional services under the Medicare Physician Fee Schedule (PFS)
Who Can Attest as an “Eligible Clinician”?
Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)
Clinical nurse specialists
Qualified speech-language pathologists
Certified registered nurse anesthetists
Registered dietitians/nutrition professionals
HOW CMS Measures Performance?
Performance in MIPS is assessed through a composite MIPS score of 100 points, encompassing all four performance categories. Eligible clinicians can participate individually or as a group using various combinations of NPI/TIN. Regardless of the chosen data submission method, scores are provided individually for individual submission and collectively for group participation