The numbers are in and things are looking good for many providers who participated in the first year of the Merit-based Incentive Payment System (MIPS) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The vast majority of those who participated will receive a positive payment adjustment in 2019.

There were three performance categories that would determine payment adjustments and if providers would receive a bonus or penalty: quality, clinical practice improvement, and advancing care information through the use of health information technology. There is a fourth category (cost) but it was not used to determine payment adjustments during the first year of the program.

Once the scores are determined based on all three categories, providers are classified into reward categories and bonuses/penalties are calculated. For providers with low scores, CMS has committed to working with those individuals through customized no-cost technical assistance. This will include identifying their needs, addressing potential barriers, and helping prepare to successfully participate in future years.

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