1. Quality Payment Program
What Is MIPS?

2. What Is MIPS?
An overview of the components of the Merit-based Incentive Payment System
Quality Payment Program
What Is MIPS?

3. Four Components of MIPS – Proposed Rule
Quality
Formerly PQRS
Advancing Care Information (ACI)
Formerly EHR Meaningful Use
NEW
Resource Use
Formerly VBM
Clinical Practice Improvement Activities (CPIA)
Quality Payment Program
What Is MIPS?

4. MIPS in the Final Rule for First Year—2017
Quality
Advancing Care Information (ACI)
Cost
(aka Resource Use)
-- sort of…
Improvement Activities
Quality Payment Program
What Is MIPS?

5. MIPS Quality Component
Replaces the PQRS reporting program
Fewer measures required
Report on six measures (previously was nine)
One outcome measure
Or other high-priority measure
Alternative
One specialty-specific measure set
Group reporting remains an option
Quality Payment Program
What Is MIPS?

6. MIPS ACI Component (Advancing Care Information)
Modifies Meaningful Use Program
Score derived in two parts
Base score = 50 percent
Five measures
Remains “all or nothing”
Performance score = up to an additional 50 percent
Only applicable IF base score is achieved
Based on reporting of six optional and four bonus measures
Quality Payment Program
What Is MIPS?

7. MIPS Improvement Activities Component
New requirement
Select from a list of 93 activities
Point system: Activities with assigned point values
10 points or 20 points
40 points for full credit
Two to four activities
20 points for some rural and small practices
Attestation: At least for Year 1
Quality Payment Program
What Is MIPS?

8. MIPS Cost Component Replaces Value-Based Modifier (VBM)
Based on available resource use measures
Claims data
No reporting requirements
No assessment in 2017
10 percent value previously assigned has been re-assigned to the Quality component
Quality Payment Program
What Is MIPS?

9. MIPS: Final Score Year 1 – Weight by Category
Quality Payment Program
What Is MIPS?

10. Note: Most Practitioners Will Be Subject to MIPS
QP in Advanced APM
Not in APM
In non-Advanced APM
In Advanced APM, but not a QP
Some clinicians may be in Advanced APMs but not have enough payments or patients through the Advanced APM to be a QP
Quality Payment Program
What Is MIPS?

11. MIPS in the Final Rule for Year 1—2017
Advancing Care Information (ACI)
25%
Quality
60%
Cost 0%
Improvement Activities
15%
Quality Payment Program
What Is MIPS?