MIPS Participation Option for 2017

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Not participating in the Quality Payment Program:

If you don’t send in any 2017 data, then you receive a negative 4% payment adjustment.

Test:

If you submit a minimum amount of 2017 data to Medicare (for example, one quality measure or one improvement activity for any point in 2017), you can avoid a downward payment adjustment.

Partial:

If you submit 90 days of 2017 data to Medicare, you may earn a neutral or small positive payment adjustment.

Full:

If you submit a full year of 2017 data to Medicare, you may earn a moderate positive payment adjustment.

MIPS Performance Categories

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MIPS Calculator

Calculator

MIPS allows Medicare clinicians to be paid for providing high-quality, efficient care through success in four performance categories:

  • Quality-Icon

    Quality

  • Replaces the Physician Quality Reporting System (PQRS)

    60%

Most participants:

Report up to 6 quality measures, for a minimum of 90 days.

Group using the web interface:

Report 15 quality measures for a full year.

Group in APMs qualifying for special scoring under MIPS, such as Shared Savings Program Track 1 or the Oncology Care Model:

Report quality measure through your APM. You do not need to do anything additional for MIPS quality.

  • Improvement-Activities

    Improvement Activities

  • New category. Minimum selection of one CPIA activity (from 90+ proposed activities) for a partial score, with additional scoring for more activities.

    15%

Most participants:

Attest that you completed up to 4 improvement activities for a minimum of 90 days. Groups with 15 or fewer participants, non-patient-facing groups and individuals and groups in rural or health professional shortage areas will attest to completing up to 2 activities for a minimum of 90 days.

Participants in certified patient-centered medical homes, comparable specialty practices, or an APM designated as a Medical Home Model:

You will automatically earn full credit.

Participants in certain APMs under the APM scoring standard, such as Shared Savings Program Track 1 or the Oncology Care Model:

You will automatically receive points based on the requirements of participating in the APM. For all current APMs under the APM scoring standard, this assigned score will be full credit. For all future APMs under the APM scoring standard, the assigned score will be at least half credit.

  • Advancing-Care-Icon

    Advancing Care Information

  • Replaces the Medicare EHR Incentive Program, also known as Meaningful Use.

    25%

Fulfill required measures for a minimum of 90 days:

  • Security Risk Analysis
  • e-Prescribing
  • Provide Patient Access
  • Send Summary of Care
  • Request/Accept Summary of Care 

Choose to submit up to 9 measures for a minimum of 90 days for additional credit.

For bonus credit, you can:

Report Public Health and Clinical Data Registry Reporting measures

Use certified EHR technology to complete certain improvement activities in the improvement activites performance category

OR

You may not need to submit Advancing Care Information if these measures do not apply to you.

  • Cost

    Cost

  •  

    0%

No data submission required. Calculated from claims.

How much can MIPS adjust payments?

MIPS will be a budget-netural program. Total upward and downward adjustment will be balanced so that the average change is 0%
Adjustment