MIPS (Merit-based Incentive Payment System) is one of two participation tracks in the Quality Payment Program (QPP) established under MACRA. MIPS streamlines three previous programs into a single program to reduce clinician burden. It provides flexibility for clinicians to choose activities and measures most meaningful to their practice to demonstrate performance. MIPS performance is assessed based on four categories: Quality, Resource Use, Clinical Practice Improvement, and Advancing Care Information. Participation begins in 2017 and payment adjustments of up to +/- 4% will apply starting in 2019 based on a MIPS Composite Performance Score. Clinicians can participate as individuals or groups.

1. MIPS
POORNESH GOKUL
PROGRAM MANAGER
SCRIPLOGIX ANALYTICS
AN INTRODUCTORY PRESENTATION

2. The Contents
What is the Quality Payment Program (QPP)?
01
What is MIPS?
02
Who is eligible? and
Who is excluded?
03
Performance Categories
04

3. Program Overview

4. Quality Payment Program
The Medicare Access and CHIP Re-authorization Act of 2015
(MACRA) requires CMS by law to implement an incentive program,
referred to as Quality Payment Program (QPP), that provides for two
participation tracks:

5. Highlights of QPP
A comprehensive approach to payment
Adds consideration of quality through a set of evidence-based
measures that were primarily developed by clinicians
The program recognizes and encourages improvements in
clinical practice
All of these efforts are increasingly supported by advances in
technology that allow for the easy exchange
of needed information while protecting patient privacy

6. Merit-based Incentives Payment
System (MIPS)
A Single program that streamlines 3 independent programs to work
as one and to ease clinician burden.
MIPS provides clinicians the flexibility to choose the activities and
measures that are most meaningful to their practice to demonstrate
performance.

7. MIPS adds a fourth component to
promote ongoing improvement
and innovation to clinical
activities.

8. MIPS Major Provisions
01 02 03
Eligibility Performance period
and payment
adjustments
Performance
categories and
scoring
04
Data submission

9. Who is excluded?
Who is eligible?

10. When does participation begin?
Jan 1, 2017
The first
performance
period opens
Oct 2, 2017
The final day to
start data
collection if you
choose to submit
at least 90 days of
data
Dec 31, 2017
The first
performance
period closes
Jan 1, 2018
-
Mar 31, 2018
MIPS data
submission period
for the 2017
performance
period
Jan 1, 2019
Payment
adjustments for the
2017 performance
period are applied

11. Yes, they can participate
either as an Individual or
Group
Note: “Virtual groups will not be implemented in Year 1
of MIPS.

12. How much can MIPS
adjust payments?
Based on a MIPS Composite Performance Score,
clinicians will receive +/- or neutral adjustments up to
the percentages below.

13. Performance Categories

14. Quality

15. Resource Use / Cost

16. Clinical Performance
Improvement Activities

17. Advancing Care
Information

18. ACI Objectives &
Measures

19. Data Submission
1. Administrative Claims
2. Claims
3. CSV
4. CMS Web Interface
5. EHR
6. Registry

20. 23%
77%
Registry-based measures count up
to 242
Claim based measures count up to 72
The Numbers for Quality
Measures

21. Thank You
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