MIPS Financial Impact

Starting in 2019, CMS has allotted additional $500M per year through 2022 towards the exceptional bonus pool. With performance scoring only impacting those clinicians with a score greater than 75 points, the potential impact of the MIPS scoring system to clinician reimbursement will be significant. There are two ways MIPS will financially impact Medicare Part B providers:

  • Inflationary Adjustment – Annual +0.5% which applies to 2016 through 2019
  • Performance Adjustment – a negative or positive adjustment based on performance

The adjustment tiers are detailed below:

Performance Year

Payment Year

Penalty

Base Incentives

Exceptional Performance Score Threshold

Exceptional Performance Bonus

Maximum Incentive

2017

2019

-4%

.28%(Actual)

15

+1.59%(Actual)

+1.88%

2018

2020

-5%

+.29%(Predicted)

70

+1.75%(Predicted)

+2.05%

2019

2021

-7%

+1.11%(Predicted)

75

+.29%(Predicted)

+3.58%

2020

2022

-9%

+9.0%

TBD

+10.0%

TBD

2021

2023

-9%

+9.0%

TBD

+10.0%

TBD

2022

2024

-9%

+9.0%

TBD

+10.0%

TBD

To learn how TriumpHealth can help you successfully comply with MIPS requirements and maximize incentives, contact us!