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