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Merit Based Incentive Payment System

What is MIPS

  • Provider Provider Payment Payment Modernization Modernization Act of 2015 created MIPS to combine and streamline the three quality quality incentive incentive payment payment programs programs (PQRS, VBM, EHR MU)
  • Payments Payments begin in 2019 after the current current incentive programs sunset in 2018
  • Not yet in fi l na stages of d l eve opment and determination of measures to be reported

MIPS Timeline

2015

  • April 15, 2015 – MIPS legislation passed
  • By December 31, 2015 – C S M to release RFI seeking more public comments

2016

  • Estimated July 2016 – Proposed 2017 MIPS rule
  • Estimated November 2016 – Final 2017 MIPS rule

Participation

  • Doctors of:
    • Osteopathy
    • Dental Medicine
    • Podiatric Medicine
    • Opytometry
  • As well as:
    • Chiropractors
    • Physician Assistants
    • Nurse Practitioners and more!

Why MIPS

  • End of other incentive incentive programs programs
  • Continue to assess performance in the areas of:
    • Quality
    • Resource Use
    • Meaningful Use
    • Clinical Practice Improvement Activities

What to Report

  • New measures published annually
  • Cturren MU and quality measure
  • Specialty or Chronic Care measures
  • Professionals will be assessed on efforts to engage in clinical practice improvement and qualify for additional bonuses

‐/+ Payment Adjustments

  • Negative Payment Adjustments
    • Capped at 4% in 2019
    • Capped at 5% in 2020
    • Capped at 7% in 2021
    • Capped at 9% in 2022
  • Zero Adjustments
    • Composite scores at the threshold will no receive a MIPS payment adjustment
  • Positive Adjustments
    • Above the threshold threshold will receive receive a positive positive payment payment adjustment
    • Higher performance scores will receive a larger payment plus bonus if exceeding a 25th payment plus bonus if exceeding a 25 percentile of th percentile of the threshold

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