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What is Quality Program?

The Quality Payment Program improves Medicare by helping you focus on care quality and the one thing that matters most — making patients healthier. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years.

  • Rerorm Medicare Part B payments for more than 600,000 clinicians
  • Improve care across the entire health care delivery system

The Merit-based Incentive Payment System (MIPS)
If you decide to participate in traditional Medicare, you may earn a performance-based payment adjustment through MIPS.

Advanced Alternate Payment Modules (APMs)
If you decide to participate in traditional Medicare, you may earn a performance-based payment adjustment through MIPS.


What is MIPS?

MIPS is currently CMS’ largest value-based care (VBC) payment program and is designed to be a major catalyst towards transforming the healthcare industry from fee-for-service to pay-for-value.


This performance category replaces PQRS. This category covers the quality of the care you deliver, based on performance measures created by CMS, as well as medical professional and stakeholder groups. You pick the six measures of performance that best fit your practice.


Promoting Interoperability (PI)

CMS is re-naming the Advancing Care Information performance category to Promoting Interoperability (PI) to focus on patient engagement and the electronic exchange of health information using certified electronic health record technology (CEHRT). This performance category replaced the Medicare EHR Incentive Program for EPs, commonly known as Meaningful Use. This is done by proactively sharing information with other clinicians or the patient in a comprehensive manner. This may include: sharing test results, visit summaries, and therapeutic plans with the patient and other facilities to coordinate care.


Improvement Activities

This is a new performance category that includes an inventory of activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care. The inventory allows you choose the activities appropriate to your practice from categories such as, enhancing care coordination, patient and clinician shared decision-making, and expansion of practice access.



This performance category replaces the VBM. The cost of the care you provide will be calculated by CMS based on your Medicare claims. MIPS uses cost measures to gauge the total cost of care during the year or during a hospital stay. Beginning in 2018, this performance category will count towards your MIPS final score.


Financial impact Under MIPS ?

  • Can Avoid 7% Medicare Penalty in 2021.
  • Can gain 7% Medicare incentive in 2021.
  • Can also gain incentive from top performer slab

Who is eligible to Participate?

If you are one of them

  • Physicians (including doctors of medicine, osteopathy, dental surgery, dental medicine, podiatric medicine, and optometry)
  • Osteopathic practitioners
  • Chiropractors
  • Physician assistants
  • Nurse practitioner
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Physical therapists
  • Occupational therapists  Clinical psychologists
  • Qualified speech-language pathologists
  • Qualified audiologists
  • Registered dietitians or nutrition professionals

And Collects at-least $90,000 from Medicare per year

You can also check your eligibility on by putting individual NPI at CMS portal


How an Eligible clinician can do MIPS in 2019?

For details Please schedule a call with AltuMed Certified Consultant at (248) 809-4754


How AltuMed Certified Consultant can help you?

Step1: Review the Current relevant data
Step 2: Decide on reporting mechanism like EHR, Claim or Registry.
Step 3:Measures Selection.
Step 4: Construct the Road map contains targeted reporting period and score.
Step 5:Training and Follow up.
Step 6:Data submission to CMS.