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Preparing for MIPS

Over 500,000 clinicians will be eligible to participate in MIPS during the first year.

Here’s what you need to know:

  • There is a positive, neutral or negative adjustment of up to 4%
  • This replaces the 9% penalties of Meaningful Use, PQRS and VBPM
  • There’s a flexible start date for data collection

You can:

  • Not participate – Receive a -4% payment adjustment
  • Submit one quality measure/improvement activity to avoid the negative adjustment
  • Submit 90 days of data – earn a neutral or small positive payment
  • Submit a full year of data – earn a moderate positive payment adjustment

MIPS Four Performance Categories

  • QUALITY - Replaces PQRS
  • ADVANCING CARE INFORMATION – replaces Meaningful Use
  • IMPROVEMENT ACTIVITIES – New category
  • COST – Replaces VBPM

Quality –60%

Most participants will report up to six quality measures (out of 271)

including an outcome measure for 90 days minimum


Via web interface: Report 15 measures for a full year

Clinicians receive three to 10 points on each quality measure based on performance against benchmarks


Advancing Care Information –25%

Clinicians using 2015 Certified EHRs:

Option #1: Advancing Care Information Objectives and Measures

Option #2: Combination of the two measure sets


Fulfill the required measures for 90 days minimum:

Request/Accept Summary of Care

e-Prescribing

Patient Portal

Security Risk Analysis

Send Summary of Care


Improvement Activities –15%

Must perform selected activities for 90 days in a row

Must attest each activity performed for the 90 days by selecting yes during reporting

Select from 93 possible clinical practice improvement activities

Clinicians will receive a score of 0 if they do not participate in an APM, a certified Patient-Centered

Medical Home or a Medical Health Home Model

(No cost category for 2017)

Check back for updates – Preparing for MIPS Year 2


Cost – 0% (the first year)

During the first year

CMS will provide feedback on performance and 12 cost measures


The cost measures will require five essential components


The goal for developing cost measures is to provide clinicians with useful, actionable information that will help lower costs and improve patient outcomes.


Are you ready?