MACRA QPP Center

Physicians Advocacy Institute

MIPS Pathway

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MIPS Overview

2019 is the third year of the Quality Payment Program (QPP) under which physicians will have the opportunity to earn bonuses, or face penalties, in the form of positive, neutral, or negative adjustments based on their performance in the Merit-based Incentive Payment System (MIPS). This resource provides an overview of the MIPS program and requirements.

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MIPS Resource Navigation Tool

This interactive tool will help you navigate what resources and support organizations are available and can provide additional information on MIPS categories, scoring, reporting, etc.

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Quality Category Overview

This resource provides guidance for the quality category for individual and small group Practices. Because the quality category is weighted at 45% of the 2019 MIPS final score, it is recommended that physicians carefully review all reporting requirements and weigh all options.

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Cost Category Overview

This resource provides guidance for the cost category and the cost measures for individual, group, and Virtual Group participants. The cost category is weighted at 15% of the 2019 MIPS final score.

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Improvement Activities Category Overview

This resource provides an overview and guidance for the improvement activities category which is weighted at 15% of the 2019 MIPS final score.

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Promoting Interoperability Category Overview

This resource provides guidance for the Promoting Interoperability (PI) category, which is weighted at 25% of the 2019 MIPS final score. 

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Promoting Interoperability Hardship and Reweighting Overview

Certain physicians and clinicians can have the PI category reweighted to 0% and have the 25% reassigned to the quality category. This resource provides information on the hardship exceptions available, including, lack of control over the availability of certified EHR technology, extreme and uncontrollable circumstances, physicians in small groups of 15 or fewer eligible clinicians, etc.

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MIPS Scoring Overview

This comprehensive resource provides details on the scoring across all MIPS categories and within each MIPS category, with a break-down of how points are allocated for quality, cost, and PI measures, and improvement activities.

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Practice Assessment for MIPS Reporting and Mechanisms

This resource provides a practice assessment checklist and outlines considerations to help you determine which reporting option (group, individual, or Virtual Group) and submission option (claims, EHR, registry, etc.) is best for your practice.

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Virtual Groups Overview

Virtual Groups participation option allows multiple solo practitioners and small practices to come together “virtually” with each other to participate and have their performance assessed collectively as a group in all four MIPS categories.

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Specialty Measure Sets

As an alternative to reporting 6 individual measures, physicians and groups may report 1 specialty measure set. This resource provides guidance for reporting a specialty measure set and includes details about the measures available within each specialty measure set.

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