MIPS: The Reimbursement Superhighway
As part of its broader efforts to reward value and quality in healthcare, DHHS is aiming to shift 85% of Medicare fee-for-service payments to the new MIPS program by the end of 2016 and 90% by 2018. Under MIPS, practitioners receive a composite performance score calculated using four weighted performance areas: quality of care (50%), resource use (10%), clinical practice improvement activities (15%), and meaningful use of certified EHR technology (25%). That composite score will determine the adjustment that will be made to the Medicare Part B base rate beginning in 2019. Adjustments will be made on a bell curve. Scoring above the mean onramps a provider into incentive payments of up to 4% in 2019, 5% in 2020, 7% in 2021, and 9% from 2022 onward. The highest performers can accelerate into bonuses up to three times the baseline – from 12% in 2019 t0 27% in 2022.