• Merit-Based Incentive Payment System

  • Background

    The Merit-Based Incentive Payment System consolidates several existing Medicare quality-improvement programs into one program, beginning in 2017. CMS finalized its 2018 rule for the new system in November 2017. Under the 2015 law that repealed the sustainable growth rate, MIPS combines the Physician Quality Reporting System, meaningful use and the value-based modifier. 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, which CMS will weight as follows for 2018:

    CMS will score physicians for each category and compare each doctor’s total composite score to a national benchmark. Physicians could earn a bonus or penalty, based on performance. These adjustments start in 2019, based on 2017 performance.

    Academy position

    The Academy is currently reviewing the final rule, which includes an official comment period. We will formally weigh in on the rule, after our review.

    What we’re doing

    The Academy is 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 won EHR exceptions for two measures in the advancing care information category that rarely apply to ophthalmology. In addition, the Academy:

    • 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 in the formation of the MIPS program.
    • Formally asked CMS to recognize for registry participation for all four categories of the MIPS program.