MIPS Overview

With the long-awaited issuance of the MACRA Final Rule, the Centers for Medicare and Medicaid Services (CMS) tried to soften the blow for small practices in the first year of the program. Depending on the 2017 data you submit by March 31, 2018, your 2019 Medicare payments will be adjusted up, down, or not at all. This flexible timeline casts a wide net and should get everyone to participate.Measurement under the Merit Based Incentive Payment Plan (MIPS), effective January 1, 2017, is to determine Medicare Part B reimbursement for the calendar year 2019.

The complex MIPS program combined three established payment programs:

  • Physician Quality Reporting System (PQRS)
  • Value-Based Modifier (VBM)
  • Meaningful Use (MU)

If your practice bills Medicare, you need to report in 2017 to avoid penalties or get the incentive payments you are owed.

CMS estimates that only 4% of practitioners will be participating in Alternative Payment Models, so 96% of practitioners will have their Medicare Part B payments determined by MIPS performance, and that includes all physicians. Unless implementation is delayed, this means that within a few months, physicians must be prepared to succeed under the MIPS structure.

MIPS program penalties will result in a physician losing 4% of his or her Medicare Part B payments unless they succeed at transitioning to this new system. However, under the current structure, physicians can achieve a small, moderate, or high positive BONUS in Medicare Part B payments within the first year. The percentage of your Part B payment at risk (and your ability to experience a bonus) changes each year so that by 2022, you could experience a -9%, or +37% adjustment!


Choose the MIPS Survival Path that is Right for You!

MIPS Survival - Avoid Penalty

Meet the minimum MIPS requirement to avoid the 4% penalty by downloading and implementing one CPIA project from the USWR. This is the most basic level of engagement, does not require a specific EHR, and can be accomplished in only 35 minutes! LEARN MORE

MIPS Survival Plus - Moderate Bonus

Participate for a MIPS bonus and begin to Thrive by submitting basic quality data to the USWR and downloading 2-4 CPIA projects from those we have already developed for your specialty. This is a deeper level of engagement that can be done with any 2014 certified EHR, and will only take a provider about 90-120 minutes to complete!LEARN MORE

Intellicure Network - Optimum Bonus

Become a member of the Intellicure Network and position yourself to truly Thrive under MIPS and qualify for the highest bonus possible with the least amount of effort. Members of the Intellicure Network are able to leverage the integration of the USWR, and Intellicure EHR...the only wound care and podiatry specific EHR able to fully facilitate the seamless execution of MIPS in alignment with a QCDR by simply navigating its standard charting process. This requires the use of the Intellicure EHR and will only take about 2-3 hours of a provider's time throughout the entire reporting year! LEARN MORE