MIPS Frequently Asked Questions

Q. What is MIPS?
A. The Merit-Based Incentive Payment System, or MIPS, is one of two payment models in the Quality Payment Program. MIPS aims to improve patient care while reducing costs of care and is implemented by measuring the performance of eligible clinicians (ECs) across categories that support these goals.

Q. What needs to be reported for MIPS?
A. MIPS reporting consists of four performance categories. ECs will receive a composite score based on their performance across all categories. Performance categories are:

  • Quality: measures the quality of care delivered, based on measures related to healthcare quality and outcomes of patient care. Quality accounts for 50% of the MIPS composite score.
  • Cost: cost of care provided, calculated by CMS based on the EC’s Medicare claim data. Cost accounts for 10% of the MIPS composite score.

Quality and Cost categories must be reported for the full calendar year.

  • Advancing Care Information (ACI): promotes the use of certified EHR technology for improved patient engagement and electronic exchange of information. ACI accounts for 25% of the MIPS composite score.
  • Improvement Activities (IA): promotes innovation and ongoing improvement to clinical activities, with a focus on areas such as coordination of care, population management, and beneficiary engagement. IA accounts for 15% of the MIPS composite score.

ACI and IA can be reported for a continuous 90-day period or for the full calendar year.

Q. What are the incentives and penalties under MIPS?
A. ECs can earn a positive payment adjustment of up to a 5% on their Medicare Part B reimbursements based on MIPS performance in 2018. ECs who choose not to participate or do not meet the minimum performance thresholds will receive a -5% payment adjustment. Positive and negative payment adjustments are scheduled to increase each year of the program, with performance bonuses awarded to the highest scoring ECs.

Q. What is Sevocity doing to help clinicians with MIPS reporting?
A. Sevocity offers workflows and real-time reporting for 24 quality measures and the ACI objectives and measures as well as guidance on 9 improvement activities for maximum flexibility in MIPS reporting. Additionally, Sevocity offers unlimited and practice-specific training for MIPS and monthly webinars to ensure practices can achieve the best scores on their chosen measures.

Q. What are the other resources available for MIPS?
A. Visit the Customer News page for a list webinars, product updates, and resources related to MIPS. CMS’s Quality Payment Program website provides the latest updates and educational materials on MIPS measures and reporting.

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