Merit-Based Incentive Payment System (MIPS)

MIPS

MIPS streamlines three quality programs, Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and Medicare Electronic Health Record Incentive Program (aka Meaningful Use), into one single program.

MIPS Eligible Clinicians (EC) will be measured on:

  • Quality (Formerly PQRS)
  • Advancing Care Information (Formerly Meaningful Use)
  • Clinical Practice Improvement Activities (New on a national level)
  • Resource Use/Cost (Formerly VBM)
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    NOTE: PQRS, Medicare MU, and VBM sunsetted on December 31,2016. Payment adjustments under these quality programs will end at the close of 2018.

    Who's Eligible?

    MIPS 2017-2018 Eligible Clinicians

    Medicare Part B clinicians billing more than $30,000 a year AND providing care for more than 100 Medicare patients a year :

  • Physicians
  • Physician Assistants
  • Nurse Practitioner
  • Clinical Nurse Specialist
  • Certified Registered Nurse
  • Who's Excluded?

    Who is excluded from MIPS?

    1. Newly-enrolled in Medicare - Enrolled in Medicare for the first time during the performance period (exempt until following performance year).
    2. Below the low-volume threshold - Medicare Part B allowed charges less than or equal to $30,000 a year OR see 100 or fewer Medicare Part B patients a year.
    3. Qualified Participant (QP) in an Advanced APM – QP receives a bonus payment for their participation in an Advance APM and are not subject to MIPS.
    When Does The Program Begin and How Is Performance Scored?

    MIPS Begins January 1st 2017!

    mips-pie-chart

    Resource Use/Cost category will not be factored into the EC composite score in 2017.

    An EC’s composite score (0-100 points) is the sum of points achieved for the identified performance categories.

    2017 MIPS Performance Threshold is set at 3 points

    EC’s composite score is compared to an overall MIPS performance threshold. Those who fall above the threshold will received a positive payment adjustment. Those who fall below the threshold will receive a negative payment adjustment. Those who fall on the threshold will receive a neutral payment adjustment.

    MIPS Payment Adjustments begin January 1st 2019.

    mips-payment-timeline

    2017 Exceptional Performance threshold is set at 70 points

    Eligible clinicians can earn up to an additional 10% if their 2017 composite score is above 70 points.

    Pick Your Pace for Participation for 2017

    Test Pace – Submit 90 continuous days of data on either one quality measure OR one CPIA OR the Base Score measures of the ACI to avoid a downward payment adjustment.

    Partial Year – Submit 90 continuous days of data on all required activities and measures in the 3 performance categories.

    Full Year – Submit a full year of data on all required activities and measures in the 3 performance categories.

    EC who do NOT participate will automatically receive a negative 4% payment reimbursement in 2019.

    MIPS data must be submitted by March 31, 2018

    Does STI offer assistance?

    Yes! Please see our MIPS Assistance Program for more details.

    Training Resources and More

    Need MIPS help? View our Training Materials below for more assistance

    Intro to MIPS

    Introduction to MIPS Webinar (Based on Final Rule)

    Introduction to MIPS Webinar (Based on Final Rule):

    This webinar provides the basics of the new quality payment program: MIPS (Merit-based Incentive Payment System). The presentation will cover eligibility, performance category requirements and scoring, Eligible Clinician’s (EC) composite score, and their Medicare payment adjustments. This presentation has been revised from our original webinar to reflect the final rule. So if you were unable to attend our original MIPS series or just need a refresher, please joins us to gain a better understanding of the new MIPS payment model. 

    A recorded version of this webinar is can also be found on our YouTube page here.

    Introduction to MIPS Webinar - Based on Final Rule (PowerPoint Slides)

     

    MIPS: Steps to Take in 2016 Webinar

    MIPS: Steps to Take in 2016 Webinar:

    This was the second webinar in our series on MIPS which was aimed at providing information on what you need to do in 2016 to avoid 2018 payment penalties under Medicare. We reviewed the 3 current quality programs: Physician Quality Reporting System (PQRS), Value-based Modifier Program (VBM) and Meaningful Use (MU).

    This series was held live from August through September 2016. A recorded version  of this webinar can be found on our YouTube page.

     

    MIPS: Steps to Take in 2016 Webinar (PowerPoint Slides)

     

    Why You Need STI’s Clinical EMR for MIPS Webinar

    Why You Need STI’s Clinical EMR for MIPS Webinar:

    This webinar explained why you need an EMR to achieve MIPS requirements.  In order to avoid 2019 payment penalties under Medicare, certain data needs to be submitted to CMS. This data will need to come from your EMR.  We reviewed our MIPS Assistance Program, which is aimed at supporting you through this process.

    This series was held 3 times throughout September and October 2016.  A recorded version of this webinar is available on our YouTube page.

     

     

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    mips quality
    MIPS: Setting Up Quality Measures

    MIPS: Setting Up Quality Measures

    This webinar will review the requirements for the Quality Performance Category; provide step by step instructions for setting up quality measures; and discuss how scoring is calculated. The Quality Performance Category is the most heavily weighted category of MIPS making up 60% of the Clinician’s composite score in 2017. We encourage all MIPS Eligible Clinicians who have not signed up for our MIPS Assistance Program to attend.

    A recorded version of this webinar is can also be found on our YouTube page here.

    MIPS: Setting Up Quality Measures Webinar (PowerPoint Slides)

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    aci mips
    MIPS: Achieving ACI Objectives and Measures

    MIPS: Achieving ACI Objectives and Measures

    The Advancing Care Information (ACI) category promotes patient engagement and electronic exchange through the use of certified EHR technology. This category will make up 25% of an eligible clinicians (EC) composite score. Many ECs may be familiar with the components of the ACI category because it is very similar to the Medicare EHR Incentive Program “Meaningful Use.” This webinar will provide you with information on the ACI requirements, how to achieve the measures/objectives and scoring. We encourage all MIPS Eligible Clinicians who have not signed up for our MIPS Assistance Program to attend.

    A recorded version of this webinar is can also be found on our YouTube page here.

    MIPS: Achieving ACI Objectives and Measures Webinar (PowerPoint Slides)

    *Learn more about the ACI Objectives and how to achieve them here.*

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    improvement activities -MIPS
    MIPS: Clinical Practice Improvement Activities Performance Category Webinar

    MIPS: Clinical Practice Improvement Activities Performance Category Webinar: (Based on the Final Rule)

    This was the third webinar in a series related to the Performance Categories that make up MIPS. This webinar is aimed at providing information on this new program that focuses on practices goals to improve care coordination, beneficiary engagement and patient safety. It will also provide updates on changes to the quality and advancing care information categories as per the final rule.

    This series will be held live from October through November 2016. A recorded version of this webinar is available on our YouTube page.

    MIPS: Clinical Practice Improvement Activities Performance Category (PowerPoint Slides)

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    MIPS COST
    MIPS: Resource Use Performance Category Webinar

    MIPS: Resource Use Performance Category Webinar: (Based on the Final Rule)

    This was the final webinar in a series related to the Performance Categories that make up MIPS.  This webinar is aimed at providing information on the differences between VBM and this category, how to submit data and the new episode-based measures.

    This series will be held live from November through December 2016. A recorded version of this webinar is available on our YouTube page.

    MIPS: Resource Use Performance Category Webinar (PowerPoint Slides)

    Additional Resources

    https://qpp.cms.gov/learn/qpp

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