MIPS Tips: Report the Basics to Avoid Dwindling Payments


Bob Atlas, a Strategic Advisor and President of EBG Advisors, Inc., and Yulian Shtern, Associate, authored an article in Healio, titled “MIPS Tips: Report the Basics to Avoid Dwindling Payments.”

Following is an excerpt:

Physicians participating in Medicare should understand how they can avoid the payment reductions levied for failing to participate with value-based payment programs. A recent report from the Centers for Medicare & Medicaid Services (CMS) indicates that nearly 500,000 clinicians will see a 2% reduction in their 2017 Medicare reimbursements for failing to participate in the Physician Quality Reporting System (PQRS). Medicare’s new Merit-Based Incentive Payment System (MIPS), which replaces PQRS in 2017, promises to escalate such fee reductions, as physicians who fail to participate in 2017 will see a payment adjustment of up to 4% in 2019. However, physicians can avoid the payment reduction under MIPS with less strenuous reporting requirements compared with PQRS.

PQRS, a quality reporting program for certain eligible professionals, was intended to increase the availability of data and information concerning certain quality measures. PQRS used a “carrot and stick” approach, rewarding participating physicians who showed positive quality measures with payment incentives and punishing non-participating physicians by way of a Medicare fee reduction. Some in the medical community criticized PQRS as being overly burdensome due to the costs and effort associated with PQRS fulfillment and the payment reductions levied against providers who fail to participate.