Merit Based Incentive Payment System

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Most Surgeons Earned MIPS Bonus Payments in 2021, Study Finds

by Victoria Bailey

Most surgical healthcare professionals participating in the Merit-based Incentive Payment System (MIPS) earned bonus payments in 2021, with urologists seeing the highest adjustment, a study published...

Regulatory Burdens in Healthcare Take Away from Patient Care

by Jacqueline LaPointe

Regulatory burdens in healthcare, such as prior authorizations, surprise billing requirements, and audits and appeals, are taking resources away from patient care as practices face more...

MGMA: Sustainable Financing Needed to Protect Rural Healthcare

by Jacqueline LaPointe

Physician and facility reimbursement for rural practices is not sustainable and is impacting patient access to rural healthcare, the Medical Group Management Association (MGMA) tells Congress in a new...

NAACOS: Medicare Payment Incentives Favor Clinicians in Fee-For-Service

by Victoria Bailey

Medicare payment incentives favor clinicians participating in fee-for-service models rather than those in advanced alternative payment models (APMs), according to the National Association of...

Study Finds MIPS Scores Don’t Reflect True Quality Performance

by Jacqueline LaPointe

A recent study out of the Weill Cornell Medical College questions whether the Merit-Based Incentive Payment System (MIPS) accurately captures the quality of care delivered by primary care...

Healthcare Orgs Urge Congress to Improve Value-Based Care Participation

by Victoria Bailey

Healthcare groups have called on Congress to extend incentive payments, revise threshold requirements, and expand regulatory waivers to address concerns about the Medicare Access and CHIP...

CMS Nixes MIPS Facility-Based Scoring for 2022 Performance Year

by Jacqueline LaPointe

Facility-based scoring in the Merit-Based Incentive Payment System (MIPS) will not be available for the 2022 performance year after recent changes to the Hospital Value-Based Purchasing (VBP) Program,...

CMS Proposes Quality Payment Program Updates in CY23 PFS Rule

by Victoria Bailey

In its recently released calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed Quality Payment Program (QPP) changes to the Merit-based Incentive Payment System...

Breaking Down Common CMS Value-Based Payment Programs

by Victoria Bailey

Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...

CMS Plans to Reweight 2021 MIPS Cost Performance Category

by Victoria Bailey

CMS will reweight the cost performance category under the Merit-Based Incentive Payment System (MIPS) for the 2021 performance period due to the COVID-19 pandemic’s impact on clinicians and cost...

Psychiatrists See Low Merit-Based Incentive Payment System Scores

by Victoria Bailey

Psychiatrists had significantly lower performance scores, received more penalties, and earned fewer bonuses in the 2020 Medicare Merit-Based Incentive Payment System (MIPS) compared to other outpatient...

Automatic MIPS Participation Exemption for Individual Eligible Clinicians

by Jacqueline LaPointe

CMS is exempting all individual eligible clinicians from Merit-Based Incentive Payment System (MIPS) participation in the 2021 performance year (PY). The eligible clinicians will receive an automatic...

Prior Authorizations Beat COVID Workplace as Top Regulatory Burden

by Jacqueline LaPointe

Prior authorizations are troubling medical groups more than regulations governing the workplace during COVID-19 and Medicare’s Quality Payment Program, according to survey results from the...

Most Group Practices Received Positive MIPS Scores For 2020 Payments

by Victoria Bailey

The majority of group practices that participated in Medicare’s Merit-Based Incentive Program System (MIPS) in 2018 received exceptional or positive performance scores for 2020 payment...

Top Challenges of the Merit-Based Incentive Payment System

by Victoria Bailey

The Government Accountability Office (GAO) analyzed performance data from providers who participated in the Merit-Based Incentive Payment System (MIPS) between 2017 and 2019 and found that some...

AHA Pens Oppositions to 2022 Physician Fee Schedule Proposed Rule

by Victoria Bailey

The American Hospital Association (AHA) has penned a letter to CMS Administrator Chiquita Brooks-LaSure detailing its concerns surrounding CMS’ proposed Physician Fee Schedule (PFS) for...

MIPS Quality Score Not Often Associated with Better Patient Outcomes

by Jill McKeon

Better Merit-based Incentive Payment System (MIPS) quality scores were rarely associated with lower rates of hospital complications during the first year of program implementation, according to a study...