Gulf Coast Regional Extension Center

What is MIPS/MACRA?

What is the Quality Payment Program?

The Quality Payment Program improves Medicare by helping you focus on care quality and the one thing that matters most — making patients healthier. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years. If you participate in Medicare Part B, you are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans, and the Quality Payment Program will provide new tools and resources to help you give your patients the best possible care. You can choose how you want to participate based on your practice size, specialty, location, or patient population.

The Quality Payment Program has two tracks you can choose:
Quality Payment Program APMs Track or Quality Payment Program MIPS Track

What is MIPS?

The Merit-based Incentive Payment System, or MIPS, is a new approach to paying for Medicare Part B items and services in which clinicians may receive an increase or decrease in their payments based on their performance in 4 areas:

  • Quality: 50% of total MIPS score, replaces the Physician Quality Reporting System (PQRS)
  • Improvement Activities: 15% of MIPS score, a new category
  • Advancing Care Information: 25% of MIPS score, replaces the Medicare EHR Incentive Program or Meaningful Use (MU)
  • Cost: 10% of MIPS score, replaces Value-Based Modifier program

MIPS Performance Categories