Things are looking good for the Merit-Based Incentive Payment System (MIPS), according to the US Centers for Medicare and Medicaid Services (CMS). According to CMS, participation in MIPS—which could be required of physical therapists (PTs) as early as next year—was just above 90% during its first year of operation.

The 91% clinician participation rate was slightly better than the CMS goal of 90%, and included particularly strong performance from accountable care organizations and physicians in rural areas, which reported at rates of 98% and 94%, respectively, according to a blog post from CMS administrator Seema Verma. Beginning in 2019, clinicians can earn Medicare payment increases or face penalties based on quality reporting data provided through the program.

MIPS is part of a broader effort by CMS to shift toward value-based payment systems through the Quality Payment Program (QPP). Under QPP, providers can choose 1 of 2 paths: reporting through MIPS, or participating in an Advanced Alternative Payment Model (AAPM). MIPS requires reporting in 4 performance categories—quality, promoting interoperability, clinical improvement activities, and cost. Providers earn points in each category, producing a total annual MIPS score, which in turn determines whether the providers earn a payment incentive, remain neutral in payment, or be subject to a penalty. Several of the data points must be reported electronically through certified EHR vendors or registries like APTA’s Physical Therapy Outcomes Registry.

Although PTs are not yet required to report outcomes through MIPS, they can participate voluntarily—an option strongly encouraged by APTA, given that all indications point to PTs being required to participate in MIPS or APMs as early as 2019. CMS is expected to make its decision on the inclusion of PTs in MIPS in early July 2018.

According to Verma, while CMS presses for broader participation in MIPS, it will remain "committed to removing more of the regulatory burdens that get in the way of doctors and other clinicians spending time with their patients" through its "Patients Over Paperwork" initiative.

"We’re also eager to improve the clinician and patient experience through our Meaningful Measures initiative so that clinicians can spend more time providing care to their patients and improving the quality of care their patients receive," Verma writes. "Within MIPS, we are adopting measures that improve patient outcomes and promote high-quality care, instead of focusing on processes."