Glossary Term

Merit-Based Incentive Payment System

The Merit-Based Incentive Payment System, or MIPS, is a pay-for-performance quality improvement program for physicians and other clinicians in Medicare. Congress created MIPS by merging several existing quality programs.

MIPS has four main performance categories: quality, cost, “promoting interoperability,” and improvement activities. Quality accounts for 30 percent of a health care provider’s MIPS score and takes into consideration patient outcomes. Cost accounts for another 30 percent of a MIPS score and is based on administrative claims and assesses them against 25 separate measures. The next 25 percent of the score is gauged on promoting interoperability. This category examines a provider’s meaningful use of health information technology, such as the use of electronic health records (EHR), e-prescribing, and patients’ electronic access to their health information. Finally, the last 15 percent of a MIPS score relates to improvement activities such as the promotion of patient safety, the coordination of care, and patient engagement.

MIPS was created under the Medicare Access and CHIP Reauthorization Act of 2015.


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