Understanding MIPs as a healthcare professional

In 2019, the Merit-Based Incentive Payment System was implemented to replace the previous Physician Quality Reporting System. But what is MIPs and what are the benefits for medical professionals?



Medicare MIPS is a new reimbursement system which is replacing the previously used Medicare programs. Its aim is to streamline the reimbursement process and provide practitioners and healthcare workers with performance updates each year based on four different criteria.

On the other hand, the PQR system is used by physicians and healthcare workers to assess the quality of healthcare they are providing to patients. This is used to understand what care the patient needs and when. Physicians can also use the feedback report within the system to compare themselves to their peers.

What are the benefits of using MIPs?

There are several advantages healthcare professionals and practices can benefit from when using the merit-based incentive payment system.

In the old process, there were three separate programs, all with potential for error and inaccuracies. This often would lead to payment penalties if the records werenot completely correct. Now that the process is streamlined into a single platform, reporting is minimal – as is the chance for error.

As the system isnot as difficult to understand as PQRS, and doesnot take as much time, your practice can be more efficient. This means patients can be seen faster, and their medical records and treatment history can be accessed much quicker – by you and the patient.

With less paperwork to file, your practice can also be much tidier, more organized and more spacious as you will need fewer storage cabinets.

What is also good about the system is that the originally entered data stays within the database – meaning there is no need to re-enter information again. You will also receive payments faster and will not need to worry about losing any paper claims – everything is electronic and uses safe, quick medical payments.

The final benefit of MIPs is that you own the software, meaning there is no monthly subscription fee.

What are the performance scores based on?

Practitioners who use the MIPs service will receive performance scores annually, to help them understand the quality of care they are providing to their patients. This score ranges from 0-100 and is based on four criteria:


This is the main criteria that incorporates what PQRS used to. It evaluates the quality of care you are providing to your patients.

Patient Engagement

Replacing the HER Incentive program, MIPs now assess patient engagement using certified electronic health record technology.


How do you try to get patients more involved in their care? This section allows you to choose activities to give your patients access to.


This criteria replaces the previous Value Based Management.

The MIPS process is making administration more streamlined and effective for practices across the country. Some were already succeeding with PQRS, but these practices and more can also succeed with the new system. Overall, there are too many benefits to Medicare MIPS to not get involved.

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