Most clinicians in MIPS earned small payment bump in first year results

CMS issued its year one performance results for participants in the Merit-based Incentive Payment System (MIPS), revealing that 93 percent of eligible clinicians received at least some positive payment adjustment for their 2017 performances.

MIPS is a track under the Quality Payment Program, which aims to align payments to providers with performance-based measures. Clinicians have the option to participate in MIPS as individuals or as a group.

2018 is the second year of the MIPS program, and the 2017 scores are used for 2019 payment adjustments. CMS reported that 95 percent of the participants, which was more than 1 million, avoided a negative payment adjustment.

While the overwhelming majority of participating clinicians had positive payment adjustments, the actual increase in payments was minimal, according to CMS, which also released preliminary MIPS results earlier this year.

“Admittedly, the MIPS positive payment adjustments are modest,” CMS Administrator Seema Verma stated.

Available funds for MIPS are required to be budget neutral, and the reporting adjustment threshold was limited to a “low level of 3 points,” according to the agency. Participants also had three options to pick the pace of reporting, including test, partial year or full year reporting.

While the program had a high participation rate, there is still “a big problem with full reporting for MIPS,” according to Drew Voytal, associate director of government affairs with the Medical Group Management Association (MGMA), who spoke about the program during the association’s annual conference in Boston in early October. MGMA has asked CMS for several changes to MIPS.

CMS noted this approach engages more clinicians to participate, and the agency expects gradual increases in participation over time.

The overall national average scores for MIPS eligible clinicians was 74.01 points, and the national median was 88.97 points. Small practices performed the worst, with a mean score of 43.46 points, while rural practices earned a mean score of 63.08 points. Still, the agency was bullish that these practices can be successful participants in the program, and the mean scores equate to neutral or positive payment adjustments for 2017, 2018 and 2019 performance years, according to Verma.