Merit-based Incentive Payment System (MIPS) and eligible Alternative Payment Models (APMs)

October 2016 - Vol. 35, No. 9

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the SGR and created two new payment update tracks: the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

The MIPS program incorporates components of the current CMS quality programs into one incentive program that will determine payment. Most otolaryngologist–head and neck surgeons will participate in the MIPS program and receive incentives and penalties through that program. Providers participating in Advanced APMs will receive a 5 percent bonus payment. The proposed date clinicians will begin reporting for the MIPS and APM programs is scheduled for January 1, 2017.

To help Members understand MIPS and APMs, the Academy’s Health Policy team has created one-page fact sheets (see MIPS and APMs, Post-SGR Payment Policy: MIPS, and Post-SGR Payment Policy: APMs) providing an overview of each program including MIPS reporting categories and Advanced APM eligibility criteria. Members are encouraged to use the fact sheets as quick references and learn more about the programs. For detailed information on the MIPs and APM programs, including how the Academy is working for you, visit www.entnet.org/content/physician-payment-reform.

MIPS and APMs Fact Sheet Post-SGR Payment Policy:
MIPS Fact Sheet
Post-SGR Payment Policy:
APMs Fact Sheet