When MACRA was signed into law in 2015, it replaced the SGR formula with the Quality Payment Program (QPP), of which MIPS is the primary payment track. Healthcare providers that choose to use the Merit-based Incentive Payment System (MIPS) are expected to report on several quality measures to determine performance and, in turn, payment amounts for Medicare and other government-funded services.
What is the Merit-based Incentive Payment System?
While quality measures and Meaningful Use were introduced some time ago, participation was voluntary until the Quality Payment Program (QPP) was signed into law. Now, providers who accept Medicare must participate in the Merit-based Incentive Payment System (MIPS) by default unless they meet participation thresholds and opt to use one of the Advanced Alternative Payment Models (APMs), which excludes them from MIPS reporting requirements.
The goal of the QPP was to ensure that payment amounts matched the quality of services delivered, whereas the SGR formula that it replaced resulted in reduced payments for most physicians. MIPS focuses on the quality of care being delivered along with critical areas, such as care coordination, to determine a physician's payout.
Under MIPS, providers that uphold certain quality standards and earn a minimum performance score can receive payment bonuses. Meanwhile, those who fail to meet performance minimums may receive payment reductions. Likewise, those who fall into the average benchmarks will receive no payment adjustments in either direction.
MIPS Reporting Categories
Providers are scored across four categories to determine their final score under the MIPS program. These areas include quality, improvement activities, interoperability promotion, and cost. To calculate the final score, quality and cost are given equal importance (each representing 30% of the calculation), followed by interoperability promotion at 25% and cost at 15%.
Therefore, in addition to ensuring the quality of patient care, providers can improve their MIPS final score (and potentially receive performance bonuses) through other activities, such as reducing costs without reducing quality or increasing quality without increasing costs.
How TempDev Can Help You With MIPS
TempDev’s team of experienced consultants, developers, and trainers are here to support enhanced accessibility, as well as customized features and templates. This enables you and your patients to have more control over data with improved transparency.
As part of our streamlining process, we help you implement the Patient Portal, API, and other tools to better support safety, patient engagement, and security. From dashboards to automation and workflow redesign, TempDev offers the comprehensive resources and tools you need to implement and be compliant with MIPS.
Contact us here or by calling us at 888.TEMP.DEV to optimize your MIPS reporting requirements.
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