When the Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program (QPP) kicked off in 2017, Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) were tasked with providing technical assistance to help eligible clinicians prepare for and participate in the program.

"I love this tool. The MIPS Calculator (version 2017) got us through the murky waters of MIPS last year.”

After setting up a QPP Service Center for providers, the Great Plains QIN—the QIN-QIO for Kansas, Nebraska, North Dakota and South Dakota—decided to develop a tool to help Merit-Based Incentive Payment System (MIPS)-eligible clinicians maximize their revenue reimbursements. Developed in 2017, the MIPS Calculator is a robust scoring and financial projection estimator designed to facilitate discussion and create opportunities for strategic planning within a practice or facility as clinicians transition to the QPP.

“I love this tool. The MIPS Calculator (version 2017) got us through the murky waters of MIPS last year” said Aaron Higgins, NCP, EHR & Quality Programs Manager at Savannah Vascular Institute.

In 2018, the Great Plains QIN updated the calculator to reflect the CMS 2018 Final Rule, holding a training event in August to help clinicians learn how to use it to select quality measures, assess performance against CMS benchmarks, decide on submission methods and earn the highest MIPS score possible.

Several QIN-QIOs throughout the country have adapted it to the needs of clinics in their states, including Quality Insights—the QIN-QIO for New Jersey, Delaware, Pennsylvania, West Virginia and Louisiana.

“Your MIPS calculator remains the most important tool I use while working with groups,” said Lisa Sagwitz, CMHP, Practice Transformation Specialist, at Quality Insights. “Some of the organizations actually cheered when it became available, and we worked through their numbers. Kudos for the stellar work you do in preparing, maintaining and sharing it.”

Moving forward, the Great Plains QIN plans to continue tweaking the calculator, collaborating with partners to expand its use and helping providers improve their MIPS scores.

“To further assist QINs and clinicians alike, development of additional MIPS calculators, geared towards other reporting and scoring methodologies, is in the works for future years” said David Athey, Data Engineer at Great Plains Quality Innovation Network. “The idea is to help individuals better understand their Medicare payment system through an easy-to-use tool that does not require them to supply us with any information to receive their performance score.  In addition to calculating a MIPS score, the calculator offers education, via narrative contained within the tool, as well citations to outside sources, such as the MIPS Final Rule to explain the reasoning behind the scoring and content.”