MIPS (Merit-based Incentive Payment System)

The Merit-based Incentive Payment System (MIPS) is a new medical reimbursement framework that consolidates different parts of three existing payment programs that sunset Dec. 31, 2018:

  • Physician Quality Reporting System (PQRS)
  • Value-based Payment Modifier (VBM)
  • Medicare Electronic Health Record (EHR) Incentive Program

To increase innovation, a fourth element, Improvement Activities (IA), has been added to MIPS, which offers its providers the flexibility to choose the most relevant and significant activities to demonstrate quality improvement in their practice.

Instead of quantity being the core of reimbursements, the emphasis will now fall on performance categories:

  • Quality (replaced PQRS and parts of Value Modifier)
  • Cost (replaced Value Modifier)
  • Promoting Interoperability (replaced EHR meaningful use)
  • Improvement Activities

An eligible clinician’s final score determines their MIPS payment adjustments.

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