MIPS Pathway

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MIPS Overview

2018 is the second 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 50% of the 2018 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 10% of the 2018 MIPS final score.

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Improvement Activities Category Overview

This resource provides an overview and guidance for the improvement activities category which rewards physicians and practices for engaging in clinical practice improvement activities. The improvement activities category is weighted at 15% of the 2018 MIPS final score.

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Advancing Care Information Category Overview

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. The ACI category is weighted at 25% of the 2018 MIPS final score.

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ACI Category Hardship and Reweighting Overview

Certain physicians and clinicians can have the ACI category reweighted to 0% and have the 25% reassigned to the quality category. This resource provides information on the hardship exceptions that can be applied for to have the ACI category reweighted, 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 ACI 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 reporting mechanism (claims, EHR, registry, etc.) is best for your practice. 

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Virtual Groups Overview

Virtual Group reporting is a new 2018 MIPS participation option. Unlike the group participation option which is limited to physicians under the same TIN/practice, Virtual Group s 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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