Maximizing your MIPS (Merit-Based Incentive Payment System) score doesn’t require overhauling your entire workflow—but it does require planning, coordination, and smart use of available tools. Whether you're aiming to avoid penalties or earn positive payment adjustments, a focused strategy can make a significant difference.
This article outlines practical steps billing and administrative teams can take to help boost performance across each MIPS category.
The quality measures you choose directly influence your final score. Select ones that:
Align with your provider’s specialty
Fit your existing workflow
Have high benchmarks or strong scoring potential
Avoid selecting measures that are difficult to document or don’t apply to your patient population. Relevance and feasibility are key.
Each MIPS category carries a different weight. Quality and Promoting Interoperability typically make up the largest portion of your score.
Prioritize these areas:
Quality: Monitor performance regularly and close care gaps before the end of the reporting year.
Promoting Interoperability: Ensure your EHR is certified and that you meet all base and performance requirements.
Stay current with annual CMS updates, as category weights can shift from year to year.
Waiting until the end of the year to review your progress puts your score at risk. Instead, run quarterly performance reports to catch any issues early.
Look for:
Measures with missing data
Patients who didn’t meet measure criteria
Unexpected drops in performance
Early adjustments can help you stay on track and improve outcomes.
Incomplete submissions can drastically reduce your score. Make sure you’re meeting the data completeness thresholds for each category.
For most Quality measures, this means reporting on at least 70% of eligible patients (based on current CMS rules). Use your EHR or registry tools to track this in real time.
Accurate documentation and correct coding are essential for MIPS success. Even small errors can prevent a measure from counting.
Train clinical staff on the documentation requirements for selected measures
Review coding regularly to ensure alignment with MIPS specifications
Perform internal audits to catch inconsistencies or omissions
Improvement Activities offer an opportunity to earn easy points—especially for small practices, which often receive full credit for just one or two completed activities.
Select activities that:
Align with current initiatives
Are already being performed
Can be well-documented and verified
Be sure to track start and end dates, staff involvement, and the activity’s impact.
Leverage your EHR system and any certified registry tools to:
Automate data collection
Track performance in real time
Simplify submission and reduce errors
These tools can save time and ensure consistency across your MIPS reporting.
Maximizing your MIPS score isn’t about doing more—it’s about doing the right things at the right time. By selecting appropriate measures, maintaining clean data, and monitoring your progress throughout the year, you can build a strategy that strengthens performance and protects your revenue.