Health Affairs October 30, 2018
In a recent post, we described nuances in MIPS scoring that can ultimately lead to discrepancies between frequently referenced (e.g., ±4% in 2017 and ±5% in 2018) and actual professional fee reimbursement adjustments.
Several implications arise from this approach. First, providers face substantial uncertainty about payment adjustments in the MIPS track. This uncertainty arises from multiple aspects of scoring calculations: (1) Medicare’s use of linear scales and scaling factors that incorporate the performance of others into clinicians’ individual adjustments, (2) the dependence on composite performance score (CPS) for determining payment adjustments, and (3) exceptional performance thresholds that Medicare can update each year. For example, the CPS threshold was increased from 3 in 2017 to 15 in 2018, but the...
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