The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) introduced a new system of Medicare payments linked to value-based care. While physicians can earn bonuses based on data reported under Medicare’s 2019 Quality Payment Program (QPP), eligible physicians who fail to report data will be subject to a 7% penalty in 2021. That penalty will rise to 9% the following year. 

To avoid such penalties, physicians need to score at least 30 points in this year’s QPP Merit-based Incentive Payment System (MIPS). The following online resources can help physicians understand whether they are eligible to participate in MIPS or are exempt, and how to avoid pay cuts (penalties) or earn bonuses in the future.

American Medical Association

MIPS 2019: Not too late to avert future Medicare pay penalties. This AMA Wire article gives an overview of MIPS and requirements for avoiding penalties and includes links to other AMA resources.

Understanding Medicare’s Merit-based Incentive Payment System is the AMA’s starting point for most physicians to understand how to qualify for incentives for reporting on activities and to avoid a penalty. Another Quality Payment Program track, advanced alternative payment models, affects far fewer practices.

MIPS Action Plan for 2019 details how a practice can take part in the incentive payment plan, or determine that the practice is exempt due to low Medicare participation. The plan covers 10 steps governing participation and requirements, and is used with a Strategic Scoring Guide to determine if MIPS-covered practices will target the 30 points required to avoid a 2021, enough points (75) for the maximum standard bonus of 7%, or even more points, in hopes of a bigger incentive.

2019 Medicare Quality Payment Program FAQs: Cost Category answers common questions about MIPS participation.

Quality Payment Program Resource Center for the Midwest

Archived webinars. “MIPS 101: An Introduction to the Merit-based Incentive Payment System (MIPS) for New Participants” and “2019 Participation in the Merit-based Incentive Payment System (MIPS),” are available through the Quality Payment Program Resource Center. 

Live webinars. Topics include data submission options, explanations of various performance categories and more.

Help for small practices and practices in rural and underserved areas: Purdue Healthcare Advisers, through the QPP Resource Center for the Midwest, assists eligible, Indiana-based clinicians in small practices and in  rural or medically underserved areas with MIPS reporting. This flyer gives an overview of MIPS and services offered to these practices.