The MIPS (merit-based incentive payment system) program was established by the Medicare Access and CHIP Reauthorization Act of 2015. It went into effect in January 2017 and is a program used to determine Medicare payment adjustments. This program was designed to tether payments to quality and cost-efficient care while promoting improvements in health outcomes and care processes. You might begin to feel overwhelmed at the thought that you are an eligible clinician that may be subjected to a payment penalty, a no payment adjustment, or a payment bonus based on the MIPS payment system. Here are the 4 MIPS reporting performance categories to focus on.
Cost or Resource Use
This category replaced the CMS Value-based Payment Modifier program and is used to evaluate you on measures related to resource utilization. This is calculated based on Medicare claims, and you should expect and plan for the increase in this category’s weight in future performance periods.
Next to resource use, quality is another performance category you should focus on. In this category, you are required to report data to CMS for quality measures in patient safety, patient outcomes, patient experience, care coordination, and more.
As its name implies, improvement activities is a MIPS reporting performance category intended to encourage you to participate in improved clinical practice activities and is valued at 15 percent of your final MIPS score.
ACI (Advanced Care Information)
ACI is a category that has replaced the Meaningful Use or Medicare EHR Incentive Program. It is used to measure how well you use EHR technology with a focus on information exchange. This category is valued at 25 percent of your final MIPS score.
These are to mention the 4 MIPS reporting categories you should focus on to prevent payment penalties and/or no payment adjustments. You should consider excelling in these categories so you can be eligible for a payment bonus.
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