According to CMS data, 87% of solo providers and almost 60% of 2 – 9 provider practices are at risk of being penalized under the new Medicare-based Incentive Payment System (“MIPS”). Don’t feel badly if you’re asking, “what is MIPS?” — you still have time to learn about MIPS and ensure you’re not penalized.
Under the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), Congress eliminated the dreaded sustainable growth-rate (“SGR”) formula, which led to the annual ‘doc fix,’ and combined the MU, PQRS and VBM regimes of bonuses and penalties. In their place, Congress created MIPS and an alternative payment model. MIPS, which the overwhelming majority of providers are expected to select rather than the alternative payment model, provides for bonuses and penalties based on the quality of health outcomes, health costs and EHR utilization.
MIPS penalties and bonuses will start at 4% and increase to 9%. While providers won’t feel the financial impact of these penalties until 2019, the performance measurement period is presently set to begin on January 1, 2017. Now is the time to learn about MIPS and take whatever steps are necessary to comply. You can learn more at http://www.ama-assn.org/ama/pub/advocacy/topics/medicare-physician-payment-reform.page or by attending one of MTBC’s upcoming webinars on MACRA and MIPS.