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3 Reasons Why Ignoring the 2017 MIPS Transition Year Could Cost You

Providers across the country are facing the challenges of learning about and complying with the new Merit-Based Incentive Payment System (MIPS), one of the two available participation tracks providers (or “eligible clinicians,” using the jargon of the program) who serve Medicare Part B patients will utilize to successfully report and avoid penalty under Medicare’s new Quality Payment Program.

In hopes to alleviate any challenges in the transition from PQRS, Value Modifier, and Meaningful Use, Medicare announced 2017 would be a “Transition Year” for MIPS, allowing Eligible Clinicians to choose one of three “Pick Your Pace” options to successfully submit and avoid a negative adjustment of 4% on all 2019 Medicare Part B reimbursements.

Perhaps, what seems to be the most appealing option for providers, is the option of submitting very minimal data to simply avoid the penalty. Metaphorically speaking, this may seem like the highly sought after “Get Out of MIPS Free Card.”

Here’s 3 reasons to resist the temptation to not fully participate in MIPS during the 2017 transition year:

Reason #1: There’s 4% on the Line

Failing to successfully submit in the “Transition Year” of MIPS will lead to an automatic 4% negative adjustment on your Medicare Part B reimbursements for the 2019 calendar year – this can have a large impact on your bottom line.

But just because it looks easy does not mean that it is. As always, there are numerous subtleties and the failure of any one of them can counter your minimal effort and cost you 4% of your 2019 Medicare revenue.

Reason #2: It’s Easy to Earn a Potential Return on Your Investment

Don’t forget, there is money to be made in the “Transition Year” of MIPS as well. And it’s almost as easy to get into the incentive range as it is to simply avoid the penalty!

In 2017, Eligible Clinicians will have the opportunity to earn a positive adjustment by scoring anything above 3 points out of 100 on their Final Score. Depending on your overall Medicare Part B billing, this has the potential to create a return on your investment that could make it worth your time and effort to fully participate in the new program for 2017.

Reason #3: You’ll Be Ready for 2018 When the Penalty Increases to 5%

Consider 2017 as the “dress rehearsal” for 2018, when the rules are full-on, unmodified, and the negative 4% adjustment for not participating in MIPS will increase to 5%. This means that all special considerations and the “Pick Your Pace” option will not be available to simply avoid a penalty. And let’s not forget the upside in 2018. The dynamics of revenue neutrality, the projected balance between the number of providers earning a positive versus negative adjustment, and the exceptional bonus lead to an estimated potential upside that could be as high as 11% for the highest scores in 2018. We’ll be able to better inform you on 2018 dynamics once CMS announces the much-anticipated 2018 Final Rule, expected to be released in November.

By putting your best foot forward in the 2017 reporting year you’ll be setting yourself up to better understand what you will need to complete for 2018 to successfully participate in MIPS.

Have questions about the 2017 transition year of MIPS? Post them in the comments below and I’d be happy to answer them. You can also contact a member of our team who will walk you through how to get started. Finally, I recently presented a webinar on getting started with MIPS; you can watch the recording here.

Read our FAQ on MACRA, MIPS, and APMs

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