The Merit-based Incentive Payment System (MIPS) is a new Medicare program that consolidates previous quality and value-based reporting initiatives into a single framework, aiming to measure and adjust clinician payments based on performance across four key categories.
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>> Molly MacHarris: Introduction to the
Merit-based Incentive Payment System, or MIPS.
I'm Molly MacHarris with CCSQ, and I will be leading
you through this discussion.
So, what is the Merit-based Incentive Payment System, or
MIPS program?
The MIPS program combines various elements of three
sun-setting programs.
Those three programs that are sun-setting, or ending,
include the Physician Quality Reporting System, or
PQRS program; the Physician Value Modifier, or VM
program; and the Medicare EHR Incentive Program for
Eligible Professionals.
Those three programs will end, and the new MIPS
program will be available to eligible clinicians.
A couple of important things to note here: the Medicare
EHR Incentive Program for Eligible Hospitals, that
will continue.
The Quality Payment Program does not impact that.
And additionally, the Medicaid EHR Incentive
Program for Professionals; that will continue as well.
The Quality Payment Program just impacts the Medicare
EHR Incentive Program for Eligible Professionals.
And as you can note on the slide here, the last
performance period for these three programs is 2016, and
the last payments that will be issued under these
programs will occur in 2018.
The MIPS program begins in 2017, with payments being
adjusted in 2019.
So, what makes up the MIPS program?
The MIPS program is comprised of four
performance categories, which include: Quality,
which is similar to the Quality portion of the
Physician Quality Reporting System; Cost, which is
similar to the Cost portion of the Physician Value
Modifier; the last performance category,
Advancing Care Information, deals with the usage of
Certified Electronic Health Records technology, so
similar to the Meaningful Use Program; and then, the
third performance category, which is listed on the slide
here, Improvement Activities, this is new.
This a category which deals with the usage of clinical
improvement, so, items such as expanded practice access,
and things similar to that nature.
These four performance categories, we will measure
performance for clinicians under these categories, and
we will issue to each clinician a final score.
So, when does the MIPS program officially begin?
The MIPS program begins January 1st, 2017, through
December 31st, 2017.
For the first year, clinicians have the ability
to pick their pace, and participate either as
minimally or as fully as they are able to.
In the first year, clinicians have the ability
to participate for a 90-day performance period, or longer.
After the 2017 performance period, all data will need
to be received by CMS at -- by March 31st, 2018.
We will then issue feedback to clinicians to let them
know how they performed under the MIPS program, and
then beginning January 1st, 2019, clinicians' payments
will be adjusted on a claim-by-claim basis.
Thank you for viewing this presentation.
For more information, please visit the Quality Payment
Program website at qpp.cms.gov.
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