MIPS 2021: Everything You Need to Know

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As we approach the second half of the year, it’s time to revisit what’s new for the Merit-based Incentive Payment System (MIPS). Major MIPS deadlines are on the horizon, and missing them could mean penalties or money left on the table. Maximizing your earnings is more important now than ever, especially as you continue to recover from the impact of the pandemic. 


The deadlines for the start of the 90-day minimum and year-long performance periods are on October 3rd and December 31st, respectively. Meanwhile, the submission period starts on January 1, 2022 through March 31, 2022, but the performance data reports won’t be due until March 31, 2022.

From updates to the physician fee schedule (PFS) and scoring system to quality performance category measures and brand new reporting frameworks, it pays to know the key MIPS 2021 changes — in this case, quite literally. 

Here’s everything you need to know about MIPS 2021 and how it can help make up for your losses due to the lockdowns and other COVID restrictions.

Additional MIPS Reporting Frameworks

On top of the original framework, now aptly called Traditional MIPS, CMS is also adding two new frameworks that eligible clinicians can use to report their Promoting Interoperability (PI) Measures and Improvement Activities

The APM Performance Pathway (APP) aims to reduce reporting burdens and create new scoring opportunities. Under the APP, clinicians are scored based on three performance categories — Quality, Improvement Activities, and Promoting Interoperability.

The MIPS Value Pathways (MVPs), the other framework, will likely not take effect until 2022. However, it will gradually transform the way clinicians participate in MIPS over the next five years. Touted by CMS as the future of MIPS, the MVPs framework will allow clinicians to report on fewer quality measures and on improvement activities that are more meaningful to your practice, specialty, or public health priority.

Quality Performance Category Measures & Scoring

For the 2021 Performance Year, CMS is bringing down the quality performance category weight for clinicians, groups, and virtual groups participating in Traditional MIPS from 45% to 40%. If you’re a clinician reporting through an APM, you will also have more control over your scores and incentives than ever. Rather than basing your scores on your individual performance, this year CMS will take the highest score instead — regardless of if that’s from your individual performance or your APM. That means more opportunities to make money.

Read More: Strategies for Supporting the Business Side of Your Practice

The positive and negative adjustments remain the same as last year, at 9%. To avoid a negative payment adjustment this year, you must earn a minimum of 60 points. And if you want to qualify for the exceptional performance bonus, which could grant you an additional sliding scale positive payment adjustment of up to 10%, you’ll need to earn 85 points.

Also, qualifying clinicians who encountered difficulties this year due to the pandemic can apply for either of two exceptions:

  • Extreme and Uncontrollable Circumstances Exemption reweights any or all MIPS performance categories for the 2021 performance year, allowing you to reweight one or more of the categories to 0%.
  • MIPS PI Performance Category Hardship Exception specifically reweights your score under the PI performance category provided that you qualify for these reasons: 
    • You’re a small practice (15 eligible clinicians or fewer)
    • You have decertified EHR technology
    • You have insufficient internet connectivity
    • You face extreme and uncontrollable circumstances such as disaster, practice closure, severe financial distress or vendor issues
    • You lack control over the availability of CEHRT

MIPS Reporting Made Easy

Coming off the heels of a challenging year, your MIPS compliance shouldn’t be an additional burden. We want you to earn more from MIPS and avoid penalties with as little inconvenience as possible, providing everything you need for a smooth and straightforward MIPS attestation.

Read More: The Biggest Changes in Medical Practice After a Year of the Pandemic

To help you get the most out of MIPS, Meditab has the tools and the team to get you through reporting for this year and the years to come. Our MIPS reporting and quality management solution includes a MIPS-ready EHR software and a team of attestation experts who will guide you every step of the way to MIPS success.

Now, more than ever, it’s essential to be on top of your MIPS performance.

Learn More


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Source : https://blogs.meditab.com/