MIPS Pathway

MIPS Overview

Under MACRA’s Quality Payment Program (QPP), physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), a new category not based on a previous program. This resource provides an overview of the MIPS pathway participation option.

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Transition Year - ACI Category

2017 serves as a transition year for the MACRA Quality Payment Program (QPP) during which physicians have the flexibility to select the level of participation that best suits their practices. Under the QPP, physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), a new category not based on a previous program. This resource provides guidance for the advancing care information (ACI) category, which replaced the Medicare Electronic Health Record (EHR) Incentive Program known as Meaningful Use.

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ACI Category Hardship/Reweighting

Under the MACRA Quality Payment Program (QPP), physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program that builds off these three previous programs and introduces a new category. In 2017, MIPS has four weighted performance categories: quality (60%), cost (0%), advancing care information (25%), and improvement activities (15%). This resource provides an overview of the hardships and reweighting for 2017 under the ACI category.

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Transition Year – Quality Category

2017 serves as a transition year for the MACRA Quality Payment Program (QPP) during which physicians have the flexibility to select the level of participation that best suits their practices. Under the QPP, physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), a new category not based on a previous program. This resource provides guidance for the Quality category for individual and small group practices, which replaced the Medicare Physician Quality Reporting System known as PQRS. 

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Transition Year – Improvement Activities Category

2017 serves as a transition year for the MACRA Quality Payment Program (QPP) during which physicians have the flexibility to select the level of participation that best suits their practices. Under the QPP, physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), new category not based on a previous program. This resource provides guidance for the improvement activities category, which is not based on any previous CMS quality reporting programs, but instead, is a new category that rewards physicians and practices for engaging in clinical practice improvement activities. 

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MIPS Scoring Overview

Under MACRA’s Quality Payment Program (QPP), physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), new category not based on a previous program. This resource provides an overview of scoring across each MIPS category. 

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Practice Assessment for MIPS Reporting Options

Under MACRA’s Quality Payment Program (QPP), physicians may choose to participate in an Advanced Alternative Payment Model (APM) or submit data to the Merit-Based Incentive Payment System (MIPS). MIPS is a new program that consolidates and sunsets the previous quality reporting programs, including the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM), and the Electronic Health Records (EHR) Incentive program (Meaningful Use), into one program. In 2017, MIPS has four weighted performance categories: quality (60%), based on PQRS; cost (0%), based on VM; advancing care information (25%), based on Meaningful Use; and improvement activities (15%), a new category not based on a previous program. This resource provides guidance on the different MIPS categories and the multiple reporting mechanisms available for MIPS reporting for each category. 

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