Difference between revisions of "MIPS"
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'''*** The more measure you report, the higher your score. | '''*** The more measure you report, the higher your score. | ||
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! scope="col" style=" background: #ddd; border:1px solid gray;"|Full potential | ! scope="col" style=" background: #ddd; border:1px solid gray;"|Full potential | ||
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| + | '''*** The more measure you report, the higher your score. | ||
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| + | '''MIPS Scoring''' | ||
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| + | '''MIPS Score'''' will be determined by four Composite Performance Scores: | ||
| + | Quality | ||
Revision as of 19:29, 29 May 2018
MIPS - Merit Based Incentive Payment System
MACRA repealed the Sustainable Growth Rate formula and created the Quality Payment Program. The Quality Payment Program changes the way Medicare pays clinicians and streamlines multiple quality programs. There are two options to choose from based on practice size, specialty, location or patient population. These are MIPS and APM (Advanced Alternative Payment Models). Most clinicians will be subject to MIPS unless they are in their 1st year of Part B participation, become QPs through participation in Advanced APMs, or have low volume of patients.
Who Does MIPS Affect? Medicare Eligible Clinicians
- Physicians
- Physician Assistants
- Nurse Practioners
- Clinical Nurse Specialists
- Certified Nurse Anesthetists
- Group that include such clinicians
CMS has provided a tool to see if you qualify for MIPS. Go to: https://www.cms.gov/Medicare/Quality-Payment-Program/Lookup-Tools/Lookup-tools.html
EXCLUSIONS
- < 30k Part B
- < = Medicare Patients
MIPS has 4 Performance Categories
- Quality (PQRS) – formerly Physician Quality Reporting System (30%)
- Cost (VM) – formerly Value-Based Modifiers (30%)
- ACI(MU) – formerly MU (25%)
- Process Improvements (15%)
MIPS Reporting Periods - 2017
| PATH 1 | PATH 2 | PATH 3 | |
|---|---|---|---|
| Requirements | Report on 1+ quality measures | IA: 90 days | IA: 90 days |
| Report on 1+ IA measure | ACI: 90+ days, less than 1 year | ACI Full year | |
| Report on All Base ACI measures | Quality: 90+ days, less than 1 year | Quality: Full year | |
| Outcomes | No penalty | No penalty | No penalty |
| No Incentive | Proportion of potential incentive | Full potential incentive |
*** The more measure you report, the higher your score.
MIPS Reporting Periods - 2018
| PATH 1 | PATH 2 | ||
|---|---|---|---|
| Requirements | IA: 90 days | IA: 90 days | |
| ACI: 90+ days, less than 1 year | ACI: Full year | ||
| Quality: Full year | Quality: Full year | ||
| Outcomes | Proportion of potential incentive/penalty | Full potential |
*** The more measure you report, the higher your score.
MIPS Scoring
MIPS Score' will be determined by four Composite Performance Scores: Quality