Updated July 17, 2018
If your practice submitted Merit-based Incentive Payment System (MIPS) data in 2017, your MIPS score and performance feedback are now available. Your penalty or bonus will be reflected in your Medicare Part B payments in 2019.
To view your score and feedback:
- Go to the Quality Payment Program website.
- Login using your Enterprise Identity Management (EIDM) credentials. If you don’t have an EIDM account, refer to this guide and start the process now.
Clinicians who were required to participate in 2017 but did not will receive a 4% penalty in 2019. On the flip side, the level of positive payment adjustments was disappointing to many practices. While the Centers for Medicare and Medicaid Services (CMS) hasn’t publicly announced the amount and distribution of bonuses, we have heard that the maximum bonus is only 2% – and that includes the “exceptional performance bonus” for those earning over 70 MIPS points. We have also heard that practices earning less than 70 points earned much smaller bonuses – many of less than .5%. The reason for the small bonuses is the MIPS program is required to be budget neutral, and the low bar for participation in 2017 meant few practices received penalties. As a result, there was less money for bonuses.
This may seem like a small return on the considerable investment needed to achieve high MIPS scores, so practices might want to rethink their MIPS participation strategy for 2018. For some, it might make more sense to do the bare minimum to avoid a penalty rather than invest in the work and expense required to achieve a high score. For help planning your MIPS strategy for 2018, refer to the College’s updated MIPS toolkit.
For more information on 2017 MIPS scores, the 2019 MIPS Payment Adjustment Fact Sheet highlights how CMS assigns final scores and how payment adjustment factors are applied for 2019 based on 2017 scores.
If you believe an error has been made in your 2019 MIPS payment adjustment calculation, you can request a targeted review at the Quality Payment Program website until October 1, 2018. The following are examples of circumstances in which you may wish to request a targeted review:
- Errors or data quality issues on the measures and activities you submitted
- Eligibility issues (e.g., you fall below the low-volume threshold and should not have received a payment adjustment)
- Not being automatically reweighted even though you qualify for automatic reweighting due to the 2017 extreme and uncontrollable circumstances policy.
For more information about how to request a targeted review, refer to the Targeted Review of the 2019 Merit-based Incentive Payment System Payment Adjustment Fact Sheet.
Questions? If you have questions about your performance feedback or MIPS final score, please contact the Quality Payment Program by:
- Phone: 1-866-288-8292/TTY: 1-877-715-6222 or
- Email: QPP@cms.hhs.gov