MIPS – A Starting Point

The new Merit-based Incentive Payment System, or MIPS, can be an overwhelming program to start. That’s why we want to offer a starting point for you as a quick guide.

MIPS is broken down into 4 categories:

  • Quality Measures
  • Resource Use
  • Clinical Practice Improvement Activities
  • Advancing Care Information

We will take these one at a time and break them down for you.

Quality Measures

Quality Measures has replaced PQRS. Now instead of 9 measures, you can choose the best 6 measures for your practice. Quality measures represent 50% of your total MIPS score. You do need to be sure to choose 1 cross-cutting measure (a measure that would apply across multiple specialties) and 1 outcome or high priority measure if the outcome measure is not applicable to your practice.

Resource Use

This is the easiest measure of all – there is nothing for you to do! Medicare will pull the data for this category from submitted claims.

Clinical Practice Improvement Activities

There are roughly over 90 proposed CPIA activities. You only have to choose one to report. However, you get additional credit if you report on more activities!

Advancing Care Information

This is what has replaced Meaningful Use. This category is showing Medicare how you are integrating patient data electronically – to other providers and to the patients. It is combined of a base score, plus a performance score, with a bonus point for participating in an immunization registry with your state. To achieve the base score, you merely need to provide the numerator/denominator or yes/no for each objective and measure. The performance score is based on selected measures for the following categories – Patient Electronic Access, Coordination of Care through Patient Engagement and Health Information Exchange. With these measures, Medicare wants to see that you are communicating with patients and other providers electronically through portals and secure electronic file transfers.

MIPS can be overwhelming, but taking time to know the basics will help you learn everything you need to know to meet your measures and receive your incentive bonus in 2019!


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