Medicare Incentive Program payment adjustments

Recent communications from the Centers for Medicare and Medicaid Services(CMS) have begun to address the transition from the Electronic Health Record (EHR) Incentive Program to the Merit Incentive Payment System (MIPS). As of right now, however, the existing regulations for Meaningful Use (including Meaningful Use Stage 3) remain in effect. We will continue to monitor the industry for upcoming policy reforms and make sure that you have the tools and resources you need to meet any new requirements with the #1 cloud-based EHR.

Payment adjustment schedule for 2016 and beyond

According to CMS data, Eligible Professionals (EPs) who did not successfully demonstrate Meaningful Use are subject to a downward adjustment to Medicare Physician Fee Schedule (MPFS) payments for covered professional services.

EP Payment Adjustment Year 2016 2017 2018
% Decrease of the MPFS amount 2% 3% 3%

Over 209,000 Eligible Professionals impacted

There are over 209,000 providers who will receive 2% cuts in their Medicare payments in 2016 for failing to meet Meaningful Use standards in 2014, and another 44,579 EPs without Medicare claims. This means that an estimated two out of every five providers in the United States are at risk of being impacted by these penalties.

Payment Adjustment More Than $10,000 Between $5,000 - $10,000 Between $1,000 - $5,000 Between $100 - $1,000 Less than $100
# of Eligible Professionals 5,700 56,000 30,400 103,000 13,900
Median Loss in Millions $114MM $420MM $76MM $51.5MM $1MM

Make sure you’re not penalized

First time participants in Meaningful Use will have an opportunity to attest from January 4, 2016 through February 29, 2016 and avoid the Medicare payment reduction in 2016 and 2017.

Practice Fusion provides award-winning Meaningful Use support to help you avoid unnecessary payment adjustments and stay on the leading edge of care. Our team of experts, online resources, and intuitive reporting tools make participating in quality reporting programs easy.

“About 4 years ago we found Practice Fusion. Since then we have been more productive, have received 2 years of the Meaningful Use incentives - hope to get YR 3 soon!”

– Pankaj Desai, MD, FACP

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