By Paula Hartman-Stein, Ph.D.
The first quality improvement system implemented by the Center for Medicare and Medicaid services (CMS) in 2007 was designed to improve healthcare quality and reward clinicians for their efforts. The newest iteration, the Merit-Based Incentive Payment System (MIPS), has similar goals but focuses on value not volume while saving money for CMS by making it more difficult for clinicians to obtain bonuses while raising penalties.
Large psychology practices that work in long-term care settings are likely to experience the greatest financial gains or losses.
According to a webinar created by Healthmonix, a mental and behavioral health registry that has partnered with the American Psychological Association (APA), a group of two eligible psychologists that billed Medicare $160,000 in 2019 and had used Healthmonix for reporting could gain an estimated 3 percent incentive and net an estimated return on investment of about $4,000. A group of 15 clinicians that billed Medicare $1 million in 2019 would net an approximate return on investment of more than $25,000.
Healthmonix charges approximately $314 per clinician per year to set up the system, track progress and send data to CMS. Large practices receive an undisclosed discount per provider. Solo practitioners or those working in groups of 15 providers or less can participate in MIPS without signing up for a registry.