Medicare Physician Payment

2019 Changes

Read about what's new for MIPS in 2019.

For a brief summary, see the 2018 vs. 2019 chart.

Resources

• The Merit-Based Incentive Payment System in 2019

• The Academy's member-only 2019 MIPS Guides
• Small Practice Roadmap
• Large Practice Roadmap
• Solo/Small Practice Survival and Quick Start Guide
• EyeNet's MIPS 2019: A Primer and Reference
• EyeNet's 2019 MIPS resources
• IRIS Registry user guide
• Glossary

The Basics

• What CMS calls the new policy: Quality Payment Program (QPP)
• Where it came from: Congress passed sweeping reform under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to replace the sustainable growth rate.
• What this policy does: It ties Medicare payments to quality and value.
• When it takes effect: Performance evaluation began in 2017, with pay adjustments in 2019.
• Fee-for-service option: Merit-Based Incentive Payment System (MIPS), which combines existing quality-reporting programs with some new elements. Most ophthalmologists will likely have to use this option.
• Alternative payment model option: These new approaches to paying for the medical care of Medicare patients incentivize quality and value. Few qualifying models currently exist for ophthalmologists.