MIPS 101

MIPS 101MIPS 101 is really just a quick overview of what in involved in the Merit-based Incentive Payment System.  Because CMS is required to implement quality payment incentives (Quality Payment Program) to reward values and outcomes, it uses the MIPS system and the APM (Advanced Alternative Payment Model.

MIPS is a newer approach to paying for Medicare Part B items and services in which clinicians may receive an increase or decrease in their payments based on their performance. Performance is measured through the data clinicians report in four areas – Quality, Improvement Activities, Advancing Care Information, and Cost. We designed MIPS to update and consolidate previous programs, including: Medicare Meaningful Use (MU), Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VBM).

MIPS 101

Quality – This replaced the old PQRS program and covers the quality of the care that is delivered, based on various measures.  A practice may pick the best 6 measures suitable for that practice.

Advancing Care Information – This replaces Meaningful Use, the Medicare incentive program for moving to an electronic medical record.  This is measured by proactively sharing healthcare information created by your practice.  This includes test results, treatment plans, and visit summaries as well as other patient information.

Improvement Activities –  This category is fairly  new and includes an inventory of activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care.

Cost – This replaces VBM.  The cost of the care you provide is calculated by CMS based on your Medicare claims.  MIPS uses cost measures to gauge the total cost of care during the year or during a hospital stay.  The cost category does count towards your MIPS final score.

The whole idea of MIPS is to correlate payments to quality, affordable healthcare and to improve health outcomes.

For more information go to:  https://qpp.cms.gov/mips/overview