The Advantages And Disadvantages Of Participating In The Merit-Based Incentive Payment System


Does your medical practice accept medicare? If so, the reimbursement schedule for treatment changed as of January 2017. This new payment schedule was part of the The Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. Under the new program, you have two options. You can accept a reduced reimbursement payment based on a flat-rate table of you can participate in the Merit-Based Incentive Payment System, or MIPS. There are both pros and cons to participating in MIPS. Learning these pros and cons will help you decide which option you should take. 

The Disadvantages of Participating in the Merit-Based Incentive Payment System

  • Calculating Merit-Based Pay is Challenging

One of the downsides to the MIPS system is that there are many modifiers which come into play when determining whether you will receive an incentive, a standard payment, or have to pay a penalty. This includes quality, resource use, clinical practice improvement activities, and meaningful use of electronic health records technology. Since there are many factors that come into play, predicting what your payment will be ahead of time is challenging, which can make it challenging to budget if the bulk of your payments come from medicare reimbursement. 

  • You Could Have a Penalty

The other disadvantage to MIPS is that you could actually be forced to pay penalties. If you opt-in to the standard, flat-rate pay system, instead of the incentive based one, you know exactly how much you will get paid every time and never have to worry about penalties. 

The Advantages of Participating in the Merit-Based Incentive Payment System

  • You Can Earn Incentives

The biggest advantage to participating in the MIPS program is that you can earn incentives. The flat-pay rate system decreased. This means you will be doing the same work for less money if you opt-in to that program. The incentive-based program gives you the opportunity to earn even more money than before as long as you follow the criteria and meet the quality requirements. 

You Know What You Need to Improve Within Your Business

The other benefit to participating in the MIPS system is that even if you don't meet your quality requirements, you learn what is expected of you and how you can improve. When you implement the changes, you improve your entire clinic or doctors office for the better. This increases quality for not only medicare patients, but all of your patients across the board. 

At the end of the day, the MIPS program is a fairly new, incentive-based program that is designed to help improve quality among medicare providers. But since the basic program was just rolled out in 2017, with other factors rolling out in January of 2018, no one knows exactly how it will work. Learning the pros and cons will help you decide if you want to enroll in the program and try it out. For more information, contact a company like C3 Partners.


20 November 2017

Learning How To Manage Finances

I still remember the day that my wife and I bought our first home. We were excited about filling the place with new furniture and looking for great area rugs. Unfortunately, before we knew it, we found ourselves deeply in debt. It was difficult to dig our way out, but over the course of the next several years, we were able to make things right. I want to teach other people how to manage finances so that they can avoid the turmoil that we went through. Financial planning might seem impossible, but with a little practice, I know it can become second-nature.