In our last few blog posts, we’ve explained the two tracks through which to participate in the new CMS MACRA rule (MIPS or APMs), or Quality Payment Program – as well as who, exactly, is eligible for MIPS, since most practitioners won’t initially participate in the APM model.
As we've gone over, MIPS adjusts traditional fee-for-service payments upward or downward based on the new reporting program. This new program will integrate PQRS, Value-Based Payment Modifier and the EHR Incentive Program, which will end at the close of 2018. Parts of each of these previous programs will be streamlined into MIPS.
*Physicians can no longer opt out by paying a penalty – all providers who accept Medicare patients must comply.
So, How Exactly Are Physicians Measured?
Physicians under MIPS measured on four categories, each of which will carry a percentage, or weight, of the total score. MIPS scores will not only affect payment, but will also affect each clinician's reputation because they will be made public. Requirements of the performance categories will also account for differences among specialties.
The total of these four weighted performance categories = A single MIPS composite performance score (CPS). The maximum negative and positive performance adjustments (incentives and penalties) will begin in payment year 2019 and increase every year after that.
Check back as we delve deeper into each performance category for MIPS and review the timeline.