Small practices expected to bear majority of negative payments under MIPS

by Richard Scott on May 13, 2016
Solo providers and small practices, take note. Under the merit-based incentive payment system (MIPS) that starts in 2017, you will get docked more than half a billion dollars in Medicare payments in the first year alone.
 
This isn't some mad-scientist math. This is what CMS itself reported in the MIPS proposed rule that arrived in late April. Specifically, CMS projects that nearly nine out of 10 solo practitioners (87%) will incur a negative payment adjustment in 2019, which is based on 2017 reporting.
 
That's more than 89,000 providers projected to lose a cumulative $300 million, compared to just 13,000 solo docs who are expected to earn a positive pay bump.
 
The picture looks slightly less grim for practices with between two and nine providers. CMS predicts that the negative payment adjustment will hit 70% of these practices, for a total of $279 million in negative reimbursement.
 
Meanwhile, practices with 100 or more providers are expected to earn $539 million in 2019, and these practices will face an loss rate of 18%, far below the numbers of other sized groups.
 
Below are CMS' projections, which appear on page 676 of the proposed rule.
 
Source: MIPS proposed rule
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