The Merit-Based Incentive Payment System (MIPS) is the name of a new program that will determine Medicare payment adjustments. Using a composite performance score, eligible professionals (EPs) may receive a payment bonus, a payment penalty, or no payment adjustment.
The Composite Performance Score is based on four performance categories:
- Quality
- Resource use
- Clinical practice improvement activities
- Meaningful use of certified electronic health records (EHR) technology
Performance for MIPS will start on January 1, 2017 and will annually measure eligible providers in four performance categories to derive a “MIPS score” (0 to 100). The MIPS score can significantly impact a provider’s Medicare reimbursement in each payment year from -9% to +27% by 2022. The four performance categories are weighted:
- 50% for quality (PQRS/VBM)
- 25% for Meaningful Use
- 15% for clinical practice improvement
- 10% for resource use
The points provided for each category will shift over time to place an increasing focus on more resource use.