MIPS, which stands for the Merit-based Incentive Payment System, is a program implemented by the Centers for Medicare and Medicaid Services (CMS) in the United States. It is designed to incentivize and reward eligible healthcare professionals for providing high-quality care and achieving specific performance measures.
MIPS reporting involves healthcare providers submitting data on various performance categories, such as quality, promoting interoperability, improvement activities, and cost. These performance categories assess different aspects of healthcare delivery and aim to encourage providers to focus on improving patient outcomes, enhancing care coordination, and reducing costs.
- Quality: This category focuses on the quality of care provided to patients. Eligible clinicians report on various quality measures that assess different aspects of healthcare, such as preventive care, management of chronic conditions, patient safety, and effectiveness of treatments. The data reported in this category is used to evaluate the clinician’s performance in delivering high-quality care.
- Promoting Interoperability (formerly known as Advancing Care Information): This category evaluates the use of certified electronic health records (EHR) and the ability to exchange health information with other providers. Eligible clinicians report on measures that assess their use of EHR technology, patient engagement through electronic means, health information exchange, and interoperability capabilities. This category encourages the adoption and effective use of technology in healthcare settings.
- Improvement Activities: This category focuses on the participation in activities that aim to improve patient care and enhance healthcare processes. Eligible clinicians choose from a list of improvement activities defined by CMS and report on their engagement in activities that address areas such as care coordination, beneficiary engagement, population health management, and patient safety. This category recognizes efforts made to enhance healthcare delivery.
- Cost: This category evaluates the cost of care provided by eligible clinicians. It assesses the total cost of care for attributed patients and compares it to benchmarks for similar episodes of care. The cost category is calculated based on claims data, and eligible clinicians are not required to submit any additional reporting for this category.
Submit2CMS is a qualified CMS registry for the MIPS Reporting 2023. For more details click here