Are you eligible for MIPS? With 2017 being the first performance year, it's imperative that you know how the Merit-based Incentive Payment System could affect your revenue cycle management. We put together a cheat sheet to help you understand your participation options with MIPS in 2017 and the financial impact it could have on your revenue cycle in the coming years.
The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 to streamline multiple value-based programs including Meaningful Use (MU), Physician Quality Reporting System (PQRS) and Value-Based Modifier (VBM).
If you opt to take part in MIPS, your Medicare Part B payment amounts will be based on your performance and the value you give to your patients. MIPS value metrics will be measured in four categories: quality, cost, advancing care information, and improvement activities.
According to CMS, nearly 600,000 clinicians will participate in MIPS under the Quality Payment Program.
If you choose to participate in the Merit-based Incentive Payment System, you will be responsible for sending accurate data by the following deadlines to earn a positive Medicare payment adjustment by 2019:
How Will MIPS Be Scored?
Starting Jan. 1, 2017, Medicare Part B eligible providers (EPs) will be measured annually in four performance categories to derive a MIPS score between 0 and 100.
That score will determine positive, neutral, or negative adjustments to each provider’s annual Medicare reimbursement.
The four MIPS performance categories and associated point values for the 2017 performance year are:
How can Practices Start Preparing for MIPS Today?
Now that the performance period for MIPS has officially begun, the sooner you put processes into place to collect performance data and adhere to MACRA guidelines, the better.
To adapt to the fast-moving changes, stay current with CMS legislative announcements pertaining to MIPS and educate your organization. A great place to start is the American Medical Association’s STEPS Forward program which offers online educational resources to help practices make the shift to value-based health care.
The “Preparing your practice for value-based care” module is ideal for beginners in that it includes the top five steps for success under the new payment model:
To maximize your MIPS score, invest in the educational and tech resources you’ll need to avoid a negative payment adjustment in 2019 and beyond.