To watch the video in full screen mode, click on "MIPS Overview" in the upper left corner.
Check out another helpful overview video for MACRA.
MIPS is a new program that streamlines 3 currently independent programs to work as one:
- Electronic Health Record Incentive Program/Meaningful Use (MU)
- Physician Quality Reporting System (PQRS)
- Value-Based Modifier (VBM)
MIPS also adds a fourth component, Clinical Practice Improvement Activities (CPIA), to promote ongoing improvement and innovation. This new program will ease clinician burden and allow clinicians to choose the activities and measures that are most meaningful to their practice to demonstrate performance.
What’s the timeline for reporting?
For 2016, physicians will continue to report the MU, PQRS, and be subjected to the VBM as separate programs. There is a 2-year lag from performance year to payment year. For 2016 reporting, incentives and penalties will be realized in 2018. MACRA states that incentives and penalties for MIPS will begin in 2019. The first performance year for MIPS will begin in 2017, making 2019 the year any adjustments in payments will be made. CMS will define the performance years for MIPS in a final rule anticipated to be published at the end of 2016.
Who is eligible for MIPS?
Exclusions from MIPS
There are 3 exclusions of providers from MIPS eligibility:
- Providers participating in an APM, as defined by MACRA, are not subject to MIPS.
- CMS will define a low-volume threshold that includes a combination of minimum Medicare patients, service volume, and/or billings below which a provider is excluded from MIPS.
- Providers who enroll in Medicare for the first time during a performance year are exempt from MIPS until the next subsequent performance year.
Last Updated: October 2016