The maximum MIPS penalty increases to -7% for the 2019 Performance Year, meaning depending on your MIPS performance, you could see a minimum of $6,300 in payment adjustments per eligible clinician come 2021. For smaller practices, not participating can cause major disruptions in practice revenue but participation in the Merit-based Incentive Payment System can sometimes be equally as costly. Here, we’ll review how smaller practices can move towards MIPS participation and how participation, while expensive, can be beneficial.