Merit-based Incentive Payment System (MIPS)

^[1]^[2]^[3]^[4]

Clinical significance

MIPS affects reimbursement via penalties & bonuses for performance across several cost & quality measures, but does not affect clinical outcomes^[3]
better physician performance on the MIPS quality score associated with better hospital surgical outcomes for some physician specialties during 1st year of MIPS^[2]

MACRA program
focuses on 4 components
- quality
- cost/resource use
- clinical practice improvement
- advancing care measures for Medicare-enrolled practitioners
supesedes the following eliminated programs:
- Physician Quality Reporting System
- Physician Value-based Payment Model
- Medicare Electronic Health Record Incentive Program

↑ Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
↑ ^2.0 ^2.1 Glance LG, Thirukumaran CP, Feng C et al Association Between the Physician Quality Score in the Merit-Based Incentive Payment System and Hospital Performance in Hospital Compare in the First Year of the Program. JAMA Netw Open. 2021;4(8):e2118449. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34342653 PMCID: PMC8335582 Free PMC article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782631
↑ ^3.0 ^3.1 Bond AM et al. Association between individual primary care physician merit-based incentive payment system score and measures of process and patient outcomes. JAMA 2022 Dec 6; 328:2136-2146. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36472595 https://jamanetwork.com/journals/jama/fullarticle/2799153
McWilliams JM. Pay for performance: When slogans overtake science in health policy. JAMA 2022 Dec 6; 328:2114-2116. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36472613 https://jamanetwork.com/journals/jama/fullarticle/2799177
↑ The Quality Improvement Program: MIPS overview. https://qpp.cms.gov/mips/overview