Health Devices & Products

How Does MIPS Work, And Why Is It Important?

Being a healthcare professional, you would probably know that MIPS has replaced the Physician Quality Reporting System (PQRS) since the beginning of the year 2019. If you have heard about this but are not sure about the way this change can improve your practice, then read on!

In this article, we are going to discuss what MIPS is in healthcare, how it works, and why it is important. If your practice does not have time to understand this software, you can always go for outsourcing medical billing services from a third party!

What Is MIPS In Healthcare?

MIPS basically stands for Merit-Based Incentive Payment System. It is software that has replaced PQRS, so we can say that it is a new payment reimbursement method in healthcare. The software comprises three old healthcare programs into just one payment software. It streamlined the following medicare programs; Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VM) Program, and Medicare Electronic Health Record (EHR) Incentive Program. In addition, this software offers practitioners updates on annual performance. These updates are based on performance in four different categories.

How Does MIPS Work in healthcare?

MIPS is a payment system that is based on performance. This system includes four performance categories. These categories offer clinicians the opportunity to select the measures and activities that have some meaning to their medical practice and score each category.

In order to create the MIPS Composite Performance Score, the performance of an eligible clinician in each of the four categories is added. This is also called the MIPS Final Score. This score is used to determine the adjustments needed in the future payment of Medicare Part B.

The categories of MIPS include the following:


This category of MIPS is concerned with the quality of care that is being delivered.

Promoting Interoperability

Promoting Interoperability (PI) is a category of MIPS that focuses and scores on patient engagement. In addition, this category also involves certified electronic health record technology.

Incentive Program

Incentive Program (IA) is a category of MIPS that covers a list of activities. These activities include accessing the ways in which patients get involved in their care and, in this way, get better care. This performance category enables you to choose the activities that suit your healthcare practice.


This is a performance category of MIPS that has replaced the current Value-Based Management software (VMB).

Why is MIPS important in healthcare?

MIPS is important in healthcare because it has several advantages. Some of its benefits include:

  1. MIPS is much easier than PQRS.
  2. The practice does not need to worry about payment penalties because of its minimal reporting.
  3. It makes your practice efficient and allows patients to get quick access to their treatment histories and other medical records.
  4. It makes your practice more organized as there is less clutter.
  5. Quick access to stored data also improves patient and provider interaction.
  6. It provides your practice more room.
  7. Information once entered remains in the database, so no need to re-enter data.
  8. Payments become quick as the cash flow is improved.
  9. Paper claims never get lost.
  10. It provides a safer way for electronic medical payment, scheduling appointments, and invoicing.
  11. It also improves the medical billing cycle as well.
  12. You can own the software or get its benefits by outsourcing medical billing services from a billing company that owns this software.

How to prepare your health care for MIPS?

Have certified EHR software in your healthcare practice

To prepare your medical practice for MIPS, ensure that your practice has up-to-date EHR software. EHR software provides many features that traditional paper-based record systems can’t. By shifting to EHR software, you can schedule online appointments, have a patient portal, and benefit from telehealth. EHR software saves your practice’s efforts and time. It is also an essential requirement by Medicare in order to get reimbursed.

Have expert professionals

Instead of briefing all of the staff, have experts that can handle all the requirements of MIPS. You can also think about outsourcing medical billing from a third party. They have professionals who stay up to date with the changes in government regulations to make the medical billing process easier for your practice.

Wrapping Up!

Today’s healthcare marketplace demands medical practices to grab every opportunity to improve their practice’s revenue. MIPS in healthcare helps with the quality of payments and care. It also tends to improve the healthcare process and its outcomes. If you stick with the requirements of MIPS, your practice will ensure financial dues from Medicare. Without a doubt, MIPS is an essential part of every medical to get it right. Outsourcing medical billing services is the best option in order to adhere to MIPS requirements. UControl Billing is a medical billing company that provides billing services at the most affordable prices. In addition, they submit MIPS data through a certified registry to CMS.

Murtaza Ali

Murtaza Ali is a digital marketing expert and creative content writer with skills in online writing, blogging, and social media marketing. He likes to share his knowledge with readers in an inspiring and motivational way.

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