Healthmonix Advisor

New Interview Question: "What’s Your MIPS Score?"

Posted by Lauren Patrick on January 18, 2018


Yes, it may be that important. My prediction is that practices, networks, and health systems will start to pay more attention to MIPS scores during the process of hiring new clinicians. In fact, at Healthmonix we have already been asked about this several times in 2017.

But why would they care? If a clinician moves to a new practice, wouldn’t they receive the score, and adjustment, for that new practice? Unfortunately for clinicians looking to start fresh, the answer is no.


MIPS Scores Will Follow Clinicians―Even Those Who Switch Practices.

For 2017, all clinicians that are eligible for MIPS will receive a score based upon their reporting (or non-reporting), either through the group(s) they bill through or individually. CMS will, in turn, provide a MIPS score for each practice (TIN) that a clinician bills through. Then in 2019, the score for that TIN/NPI will create an adjustment to all reimbursements for that TIN/NPI.

RELATED: MIPS Total Points Calculation [Video]

What many clinicians don’t realize is that CMS will take the best MIPS score they had for 2017 and will use that score for all reimbursements. If a clinician belonged to a practice that did not report in 2017, all reimbursements for that clinician will be impacted with a negative four percent adjustment throughout 2019, even if they move to a new practice.

Therefore, if a practice, network, or health system is hiring a new clinician, that clinician’s score from 2017 can be a factor. If a practice scored highly in 2017 and is receiving an incentive on all reimbursements, and if a clinician with a low MIPS score joins that practice, the practice will receive a lower reimbursement rate for those claims.

It’s unclear exactly how significant of a factor MIPS scores will become in the clinician hiring process, but the scores that a given clinician achieved in 2017, 2018 and beyond will affect the revenue of his or her employer in future years. Therefore, you can be sure that employers will care how those scores compare against other applicants.

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Topics: PRO Tips, MACRA & MIPS, Physician Compare, Industry insights