MIPS Eligibility Letters and Physician Reputation – MACRA Monday

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Anshu Jindal has a great post up on the My MIPS Score website that talks about the MIPS Eligibility letters that so many people have been waiting for to know if they are required to participate in MIPS or if they are exempt from participating in MIPS.

Here’s a sample eligibility letter that they shared:
MIPS Eligibility Letter from CMS

There are a number of interesting options available based on if your group TIN is eligible to be included in MIPS or not and if your providers are eligible or not at the NPI level. In the post mentioned above, Anshu does a nice analysis of the financial impact of choosing to participate in MIPS at the TIN level vs the individual provider level or vice versa. The financial impact can be quite large for your organization and so you’ll want to go through that post and see what this means for your practice.

As they also mention in their post, the short-term financial impact of not participating in MIPS could be more than most people realize. However, not having a MIPS composite score could have an even larger impact on your long-term reputation. The more I’ve considered this idea, the more I’ve realized that a lot of practices that choose to opt out of MIPS are going to get blindsided by this.

This is true for those that choose the most basic pick your pace option as well. When a potential future patient sees that you have a very low MIPS score on one of the consumer facing physician rating websites, they’re not going to know how to appropriately assess what a low MIPS composite score means. They’ll naturally (and quite often incorrectly) assume that a low MIPS composite score means that you’re a poor doctor. Most of these rating websites aren’t going to educate their end users on how to properly interpret the MIPS score and your reputation will suffer if you have no score or if you purposefully choose to get a low score.

I know quite a few doctors who are choosing to not participate in MIPS out of principle. In some areas where there is more demand for doctors in their specialty than supply, then it might not be a huge issue. However, in a lot of areas, not participating in MIPS could potentially have a significant impact on your reputation. Sad, but true.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • Not a single patient looks up MIPS scores, Open Payments, nothing. I can tell you from experience. They could care less. All they care about is that you took good care of their family, friend or coworker. Thats it. If we are penalized too much, we will literally close open appts for Medicare patients. We would NOT be the first to do that. Look at Mayo, they already sent out a memo on it. We may still accept it but if you want an appt, see you in 6 months. We are so busy because of the rash of retirements of hard working great MDs that have had enough of the burdensome, current state of medical practice, we literally have patients waiting in the hallway outside our regular waiting room. At some point, it will break soon.

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