Performance measurement begins in 2017

Different Payment Pathways:

Merit-based Incentive Payment System, or MIPS

or Alternative Payment Models, or APMS

Eligible Clinicians

Default payment pathway for clinicians, other than those with low Medicare volume or participants in advanced APMs.

Alternative to MIPS for clinicians with significant participation in risk-bearing APMS.

Payment Impact

Sliding scale bonuses and penalities ranging from 4 percent to 9 percent, starting in 2022

Bonus of 5 percent of Part B professional services payments in 2019-2024.

Evaluation Criteria

Performance evaluated based on:

  • Quality
  • Resource use
  • Improvement activities
  • Advancing care information (electronic health records)

Percentage of care delivered through an advanced APM; individual APMs incorporate cost and quality metrics but with no impact to bonuses.