More than two-thirds of the 10,498 submissions from ophthalmologists through the Academy’s IRIS® Registry to the 2019 Merit-Based Incentive Payment System qualify to receive an exceptional performance bonus, even without adding points for the cost measure.
The bonus will be applied to physicians’ Medicare Part B service payments in 2021. The data includes submissions from ophthalmologists identified by their national provider identifier/tax information number (NPI/TIN) combination under MIPS.
As in past years, the IRIS Registry provided ophthalmologists with a distinct advantage in the program. Ophthalmologists in practices whose electronic health records (EHRs) were integrated with the IRIS Registry tended to have higher MIPS scores, according to an Academy analysis of IRIS Registry data.
An overwhelming 78% of those whose EHRs were integrated with the IRIS Registry qualified for a 2021 exceptional performance bonus.
For the quality measurement, 88% of the EHR-integrated participants scored either the maximum or within five points of it, largely due to the availability of outcome and electronic measures in the IRIS Registry.
The average MIPS preliminary score for those participating in the IRIS Registry was 74.82 out of 85 points (The cost measure, which is potentially an additional 15 points, was not included in this analysis). The threshold for the exceptional performance for 2019 MIPS was 75 points.
Because the Centers for Medicare & Medicaid Services applied an extreme and uncontrollable circumstance hardship for practices that did not submit 2019 MIPS data due to difficulties with COVID-19, the bonuses may be lower than past years. It will likely be limited to the $500 million that Congress established for exceptional performance but fewer physicians will qualify.
For 2019, CMS made it more difficult to achieve an exceptional performance bonus with a higher score threshold, limited points for topped-out quality measures and established criteria for promoting interoperability that was more difficult than in past years.
The data is preliminary, and CMS has not yet provided the points for the cost measure. More ophthalmologists could receive exceptional performance bonuses based on their final CMS score.
Updated July 23, 2020
Past years have shown consistently that the IRIS Registry has helped physicians get higher scores.
Ophthalmologists with the IRIS Registry scored higher than the average MIPS program participant, according to just released information from 2018 from CMS. For those signed up with the IRIS Registry, the average score for individuals was 70.53 and 87.12 for groups, compared with an overall average score of 52.44 for individual and 82.88 for group submissions for all MIPS participants.
Higher scores reflect both the Academy’s efforts in developing multiple outcome measures that are available for member use and the ease and accuracy of IRIS Registry-based reporting. These higher scores translate into penalty avoidance and bonus payments.