Quality, Technology, Improvement: How MIPS Improves an Office’s Performance

MIPS is a new program under MACRA that penalizes doctors and their staff if they fail to keep their offices up to par. The Merit-Based Incentive Payment System (MIPS) works by giving doctor’s offices a score that comprises a number of different categories related to their practice. The higher the score, the higher the reimbursement rates.

The details of MIPS debuted at the end of 2016, and replaced the Sustainable Growth Rate formula to MIPS (along with Advanced APMs.) MIPS was meant to be a way of combining certain existing features of Medicare into a structure that’s easier to follow. It should be noted that all offices under Part B would need to update their practice to stay compliant with MIPS. Learn more about how the metric works to improve patient care. Quality

Under MIPS, clinicians have to provide data to CMS that shows the efficacy of their treatments (including patient safety.) Offices also have to show they’re using medical resources appropriately, and coordinating treatment plans correctly. Finally, patient satisfaction will also be factored into the final quality score. These components account for 60 percent of a doctor’s total score, so MIPS gives strong incentives for doctors to get their numbers up as much as possible.


Hackers know that healthcare institutions will pay good money to get their systems back up and running, which automatically make them a very attractive target. With sensitive health data on the line for so many patients, MIPS demands physicians use compliant EHR technology to ensures all potential HIPAA, PII and PHI violations are stopped in their tracks. Without compliant software, doctor’s risk losing up to 25 percent of their total score from MIPS.


Improvement activities count for the final 15 percent of a physician’s score and are typically general steps towards improving how an office functions. No matter how efficient the practice, there can always be improvements made as to how staff communicates with one another, how patients are protected, and how final decisions are made. If there are significant problem areas, MIPS encourages physician’s to address them sooner rather than later.

The bottom line is the government wants to provide funding for physician’s offices who prove their worth by running the best possible practice. The concept for MIPS isn’t difficult to understand for those in the healthcare industry, but it can be difficult to define. It’s made even more complicated because MIPS allows doctors to decide how and what makes their office valuable to the public, thus putting the onus on administration staff to juggle the paperwork and make important decisions that could affect the future of the office.

In addition, because change seems to be the only constant in healthcare, many offices only have so much time to devote to MIPS. A full 94 percent of physicians aren’t sure when to even begin when it comes to predicting their score. One of the smartest (and most definable) steps an office can make is to update their technology as soon as possible if it’s not already compliant. The right EHR doesn’t just keep hackers away, it can actually improve patient care, staff communication, and physician accuracy. If you’re looking for a sustainable solution that addresses many of the metrics of MIPS, then you should start with the way you access your information.