MIPS Financial Calculator

Under Merit based Incentive Payment System (MIPS), the Payment Adjustments are based on the performance of the Eligible Clinicians. There are four performance categories under MIPS – Quality, Cost, Improvement Activities and Advancing Care Information. The performance score of each of these categories, multiplied by its weightage is aggregated to arrive at the MIPS Composite Score. The MIPS Financial calculator helps you calculate the projected adjustments for payment years 2019 and beyond based on the performance in the years 2017 and beyond.

1) # of Providers: Enter the Number of Providers billing Medicare Part B.

2) Average Annual Revenue/Provider($): Enter your annual average Medicare Part B revenue per provider per year.

Scores under Performance Categories:
Enter the performance scores under the different categories for the performance years 2017, 2018, 2019 and 2020.

3) Quality: Enter the projected score for Quality Performance Category. There are 6 measures to be reported under Quality, and each measure is scored points ranging from 3-10, making a total of maximum 60 points. For groups of 16 or more providers, there is an additional hospital readmission measure which would be calculated from administrative claims, making the maximum possible points of 70.

4) Cost: Enter the projected score for Cost Performance Category. For 2017, Cost will not be scored.

5) # of Measures: Enter the no. measures attributed i.e. those meeting the low case volume threshold of 20. Maximum possible score is based on the number of measures attributed to MIPS eligible clinicians through their claims data. This includes Total per capita costs for all attributed beneficiaries, Medicare Spending per Beneficiary (MSPB) and up to 10 episode-based measures.

6) Improvement Activity: Enter the projected score for Improvement Activity Performance Category. There are 93 activities weighted as high and medium. 20 points are awarded for high weighted activity and 10 points for medium weighted activity. Maximum points possible is 40.

7) Advancing Care Information: Enter the projected score for Advancing Care Information Performance Category. Maximum points possible is 155 (50 base points for required measures + 90 performance points for additional measures + 5 bonus for reporting to public health registries + 10 bonus points for end-to-end electronic reporting). The points are capped at 100.

Calculate:
Calculates the Composite MIPS Score based on the Weightage distribution, Incentive %, Exceptional Performance Incentive % and the incentive amounts for the payment years 2019, 2020, 2021 and 2022.