The Merit Based Incentive Payment System (MIPS) is a value-based payment system that is transforming the world of healthcare. The larger program which houses MIPS is known as the Quality Payment Program (QPP). The overall goal of this system is to improve the type of services that are provided in a clinical setting. At the end of the day, MIPS streamlines a few different pay-for-performance systems. Yet, there are many other aspects of MIPS reporting that you should be familiar with.
A Look at Participation
When it comes to taking part in MIPS reporting, physicians have a couple of different options. First, a clinic can opt to participate as a group. However, it is also possible to participate as an individual. In the latter case, the individual needs to report using an NPI number. This NPI numbers is then attached to a TIN. Similarly, clinical staff that wishes to report as a group would use separate NPI numbers connected to a one TIN. This is the basic structure used for identification in reporting.
Initially, MIPS had a transition year to allow service providers to make the applicable changes. Participating Medicare providers were allowed to do so during 2017. The stages of implementation include the test pace phase, the partial year, full year and Advanced Alternative Payment Model. Certain requirements must be met at each stage to avoid payment adjustments.
The Main Categories
The performance-based aspect of MIPS is divided in to four different categories. First, there is a quality category that comprises approximately 60% of the total score. Second, there is an Advancing Care Information category that measures how EHR technology is used. Next, the improvements activities section promotes activities that will increase the quality of the work done. Finally, cost category determines whether clinics are using their resources to the best of their ability. Each of these categories are used to form a score that is a major factor in Medicare Part B payment determination.
Learning More About MIPS
There is a lot more to the MIPS system than discussed here. In order to become more knowledgeable, you’ll have to explore the topic at full length. For the quickest solution, you can always work with a data solutions provider to keep up to date.
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