The Merit-based Incentive Payment System (MIPS) is the subset of rules under the Medicare Access and CHIP Reauthorization 
Act of 2015 (MACRA) which helps determine how Physicians will be compensated for their services. MIPS is a conglomerate of three prior Medicare payment programs known as the Physician Quality Reporting System, the Value-Based Payment Modifier Program, and the Medicare Electronic Health Record Incentive Program.
Presently, providers may choose to use an Alternative Payment Model (APM) instead of MIPS. The goals of MACRA
programs are divided into four categories. Quality, Cost, Promoting Interoperability (PI), and Improvement Activity (IA). While APM functions similarly to MIPS with how practice data is gathered and reported, there are lower financial risks associated with failing to meet an established goal. In 2021, for example, 7% bonus on 2021 Medicare reimbursements; conversely, failure to meet these goals might result in a -7% penalty. In 2022, this will change to a +9% bonus and a -9% penalty.
The Impacts of COVID-19
The future of healthcare remains uncertain amid ongoing concerns and COVID-19. Following the lockdowns of 2020, CMS relaxed MIPS requirements and offered exemption from reporting. In November 2021, CMS announced it would extend similar COVID-19 related exemptions for the 2021 calendar year in the Final Rule as well. While ripple effects from the pandemic will likely be felt for years to come, banking on a third year of exemptions in 2022 would be risky and not advisable.
Coming Up
This post is the first in a multi-part series intended to assist healthcare administrators and medical providers better understand major changes in our national health system. Our next post will cover specific changes with Quality and Cost standards in 2022 reporting.
To learn more, please stay tuned as Bright Ideas Medical Consulting will keep you in the know.