MIPS: What your practice needs to know

By Aine Cryts

Starting in 2017, physician practices will have a new acronym to worry about: That's MIPS or the Merit-Based Incentive Payment System.

MIPS will measure Medicare Part B providers in four different performance areas to come up with a score (0 to 100 points). Providers need to pay attention to these scores for two reasons: a negative score could impact their Medicare reimbursement and the scores will be available to consumers on the Physician Compare websiteaccording to an article in Physicians Practice.

"The majority of our members are just now waking up to the fact that the world around them is changing," Jennifer Gasperini, director of health policy for the North Carolina Medical Society, told the publication. "We would recommend they do some work to get ready now. The longer you wait, the harder it is going to be. Get familiar with existing quality programs and understand the timelines for this new structure that has been set up through [the Medicare Access and CHIP Reauthorization Act]."

Here's what practice leaders need to know, according to the article:

  • MIPS will combine the meaningful use EHR incentive program, the Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier (VBM).
  • Starting in 2019, providers' Medicare reimbursements could be impacted positively or negatively by 4 percent. That percentage will increase gradually to 9 percent in 2022.
  • 2016 will be a "rehearsal year," for MIPS. Since this program focuses on meaningful use, PQRS and VBM, practices should continue to develop these capabilities and align their staff and processes under these initiatives, Tom Lee, founder and CEO of Chicago-based consulting firm SA Ignite, told Physicians Practice.
  • Practices that are Patient-Center Medical Home (PCMH) Level III-certified by the National Committee on Quality Assurance throughout 2017 are automatically eligible for 15 points.
  • While the MIPS framework is defined by legislation, it remains to be seen how the Centers for Medicare & Medicaid Services will administer the scores. Because of this uncertainty, practices should focus on improving their performance in existing programs, David Wofford, senior manager at ECG Management Consultants in San Diego told Physicians Practice.

To learn more:
- read the article

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