MIPS: Will You Earn More or Less Money?

Leigh Page


June 22, 2016

In This Article

What Exactly Is MIPS, and How Does It Affect Me?

Physicians cheered when the sustainable growth rate was repealed. But there was never a doubt that something would replace it. And now that it's almost here, some are struggling to understand it and are still wondering how it will change their lives and income.

Starting in January 2017, most physicians in Medicare will have to report a completely reworked set of quality and efficiency measures under a new program called the Merit-Based Incentive Payment System (MIPS).

"MIPS is big news for physicians, but many aren't yet taking it seriously," says Jonathan Burroughs, MD, a consultant in North Conway, New Hampshire, who has been helping physicians transition to the new system.

By requiring physicians to report value-based measures, MIPS is part of a larger movement toward paying physicians for quality and value, but many physicians don't understand these implications, says John Peabody, MD, PhD, president of QURE Healthcare, a San Francisco-based company that measures clinical quality of practices.

The new reporting system will replace the three current Medicare reporting systems—the Physician Quality Reporting System (PQRS), the value-based payment modifier, and the meaningful use (MU) program for electronic health records (EHRs)—and it will add a new category for reporting on clinical practice improvement activities.

On April 27, the Centers for Medicare & Medicaid Services (CMS) issued a 962-page proposed rule[1] that plots out the MIPS implementation, among other things. CMS' final rule, which will be much more detailed, is expected in October.

Eligible clinicians in MIPS include physicians as well as nurse practitioners, physician assistants, clinical nurse specialists, and nurse anesthetists. Later, other nonphysicians will be added.


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