It's time to shake your MIPS

Thursday, January 26 2017

MIPS man"MIPS" ...the sound of these four letters certainly won't make you want to dance. But you are most likely going to have to learn the steps soon.

MIPS, or the Merit-based Incentive Payment System, affects the majority of clinicians billing under the Medicare Physician Fee Schedule, roughly 92-95% of clinicians billing Medicare Part B. Of those clinicians, approximately half will be excluded from MIPS in performance year 2017, due to several factors. The rest will be eligible to report MIPS, and the good news is that it’s not too late to get into the "swing" of things (I know...I'm taking this pun too far). 

MIPS is a new program for certain Medicare-participating eligible clinicians (ECs), and brings with it payment adjustments based on performance on four categories: quality, cost, advancing care information, and improvement activities. Given the wide diversity of clinical practices, and the recognition of the challenges faced by clinicians in understanding the requirements and being prepared to participate in this new program, the 2017 performance year has been designated a “transition year” by CMS.  In order to provide ECs flexible options to submit MIPS data, CMS is allowing them to pick their pace of participation for their first performance year. 

There are three participation options for ECs in 2017:

Pick Your Pace Infograph

Eligible Clinicians choosing to:

  • "test” the program must submit a minimum amount of data (1 Quality Measure or 1 Improvement Activity or 4 Advancing Care Information Measures); and will earn a neutral adjustment in 2019.
  • partially participate in the program must submit a minimum of 90 days of 2017 data; and may earn a positive adjustment* in 2019.
  • fully participate in the program must submit a full year of 2017 data; may earn a positive adjustment* in 2019.

*Positive adjustments are based on the performance on the data submitted, not the amount of information or length of time submitted! In order to achieve the highest possible final score, ECs are encouraged to submit measures and activities across all categories. 

Maybe you start off planning to only test the program, but find that partial participation is the best option for you.  Maybe you plan for the full participation year, but scale back because you really need to focus on another initiative within your practice. That’s the beauty of the transition year and the three Pick Your Pace can pick the pace that works best for you and your practice, while still participating in the program and avoiding any negative payment adjustments. Sure, there will be ECs that choose not to participate in MIPS. For ECs that do not send in any 2017 data, they will receive a -4% payment adjustment in 2019. But if you’re ready to jump into the MIPS program this year, PHA is there to help you through it. For more information, go here, sign up for this conference on February 16, 2017, in Indianapolis, and/or contact me by email or phone.

Writer: Natalie Stewart, 765-496-1265,

Tags: Quality Services

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