• Merit-Based Incentive Payment System

  • Background

    The Merit-Based Incentive Payment System (MIPS) consolidated several existing Medicare quality-improvement programs into one program, starting in 2017. The program aims to encourage provider-driven efficiency, to ensure quality care and reduce overall costs for the program. As under those programs, physicians who fail to comply with MIPS requirements face future penalties. View the Academy's guide to reporting under MIPS.

    MIPS includes four reporting categories. For 2023, CMS has proposed to keep the 2022 weights:

    The Centers for Medicare & Medicaid Services (CMS) scores physicians for each category and compares their total composite score to a national benchmark. Physicians could earn a future bonus or penalty, based on performance.

    Academy Position

    The Academy wants to ensure ophthalmologists can successfully participate and get fairly reimbursed under this program. We routinely review and comment on the proposed and final rules that update the program each year.

    What We’re Doing

    The Academy’s IRIS® Registry has helped ophthalmologists avoid over $1 billion in penalties under MIPS. We’re working to ensure that requirements for MIPS do not place significant administrative burdens on physicians trying to succeed, and that specialists and particularly ophthalmologists are not at an unfair advantage. The Academy also:

    • Convened medical society leaders to strategize how to shape the MIPS program
    • Has met with high-level CMS officials several times to advocate for ophthalmologists’ success in the program
    • Formally asked CMS to recognize for registry participation for all four categories of the MIPS program

    Resources