Merited-based Incentive Payment System Paper

Merited-based Incentive Payment System (MIPS)

The Merited-based Incentive Payment System (MIPS) is one of the fundamental provisions established under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The provision requires medical practitioners or their groups in the US to report data regarding healthcare quality, improvement activities, cost, and the utilization of electronic health records to the Center for Medicare and Medicaid Services (CMS) (Berdahl et al., 2019). Through the data provided to the CMS, medical practitioners receive fee-for-service reimbursement for good performance and penalties for poor performance.

Merited-based Incentive Payment System Paper

Although the MIPS program attracted varied opinions from healthcare workers, it is essential to participate in such an initiative to empower individual skills and foster quality healthcare service delivery. Also, MIPs encourage Primary Care Physicians (PCPs) to acquire new technologies to replace the traditional ones. Such improvements are vital records in confirming the program as effective and suitable for developing healthcare systems.

Regardless of whether primary care physicians and other medical practitioners participate in the MIPS program or not, they should align their activities to the standards set by the CMS. For instance, many practitioners’ primary concerns about the MIPS initiative are the diversion it may create as staff members concentrate on data entry rather than patient care (Austin et al., 2017). The CMS advocates for quality measures such as applying meaningful and patient-centered outcomes, balancing time and resources necessary for proper data reporting, and process transparency (Berwick & Gilfillan, 2021). With the current need to foster Patient-oriented care, the MIPS program is essential in bolstering quality services. While embracing the intervention, physicians should align their practices to the CMS’s standards to avoid contradiction.

References for Merited-based Incentive Payment System Paper

  • Austin, J., Black, B., & Pronovost, P. (2017). A Standard-Setting Body for US Health Care Quality Measurement. American Journal of Medical Quality33(4), 434-439. https://doi.org/10.1177/1062860617741977
  • Berdahl, C., Easterlin, M., Ryan, G., Needleman, J., & Nuckols, T. (2019). Primary Care Physicians in the Merit-Based Incentive Payment System (MIPS): A Qualitative Investigation of Participants’ Experiences, Self-Reported Practice Changes, and Suggestions for Program Administrators. Journal of General Internal Medicine34(10), 2275-2281. https://doi.org/10.1007/s11606-019-05207-z
  • Berwick, D. M. & Gilfillan, R. (2021). Reinventing the Center for Medicare and Medicaid Innovation. JAMA, 325(13), 1247–1248. doi:10.1001/jama.2021.3203