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Practice Fusion · Mar 2, 2017

Transitioning from PQRS to MIPS: 3 Tips for Small Practice Providers

Transitioning from PQRS to MIPS

3 Tips for Small Practice Providers:

  1. Review and understand your 2015 Quality and Resource Use Report (QRUR)

  2. Determine your MIPS eligibility

  3. Document all patient encounters in the EHR

For providers that have participated in the Physician Quality Reporting System (PQRS) program in past years, and even for those that did not, the complex requirements created by the Centers for Medicare and Medicaid Services (CMS) for the Merit-Based Incentive Payment System (MIPS) can be daunting. Below we have outlined a few things that you can do as a small practice provider to set yourself up for MIPS success in 2017.

  1. Review and understand your 2015 Quality and Resource Use Report (QRUR). Carefully review your 2015 Annual QRUR and the CMS resource “Understanding Your QRUR” so that you know how to apply that information to actions you take this year. You can access a QRUR on behalf of a group or solo practitioner at

  2. Determine your MIPS eligibility. CMS has designated 2017 as a “transition year,” which means that many small practice providers may be exempt from the MIPS payment adjustments that will be applied in 2019. Review the requirements for MIPS eligible clinicians, as well as the exemption criteria, to determine whether you need to take action this year to avoid a 4% negative payment adjustment in 2019.

  3. Document all patient encounters in the EHR. The MIPS program moves Medicare providers to a performance-based payment system, one that rewards the use of health IT and high quality care delivery. The program also applies to all of your patients, not just patients that use Medicare Part B. By thoroughly documenting all of your patient encounters using the Practice Fusion EHR, you’ll be setting yourself up to report comprehensive data to CMS that best reflects your overall patient care.

One of the challenging things about MIPS is that there are multiple options for how an eligible clinician can participate in MIPS. Further, the requirements for successful participation in MIPS are different depending on the option chosen. However, eligible clinicians do not need to select a final participation option just yet. CMS does not require registration for the program and providers can make a decision about participation at any point during 2017. Check out Practice Fusion’s Quality Payment Program (QPP) Center to learn more about the options and requirements for MIPS participation in 2017.