Smaller MIPS leads to smaller payouts for large health systems

For the second year in a row, the CMS proposed that physician practices with less than $90,000 in Medicare revenue or fewer than 200 unique Medicare patients per year would be exempt from MIPS.

Under MIPS, doctors must hit certain quality thresholds. Those who don’t must pay a penalty that is redistributed to the high performers.

So as more doctors get a pass, the size of the incentive pool has shriveled substantially. With all the opt-outs, approximately 40% of the 1.5 million doctors billing Medicare will have...