UPDATE: Your 2019 Medicare Part B Payment Increase

Augusta Care Partners participates in the Medicare Shared Savings Program (MSSP) as a Track 1 Accountable Care Organization (ACO). Track 1 ACO participating practices (like yours!) are assessed under MIPS using the Alternative Payment Model (APM) Scoring Standard. This means that all of our participating practices receive the same MIPS score.

What Is MIPS, and what does MIPS have to do with my practice?

The Merit Based Incentive Payment System (MIPS) is Medicare’s medical reimbursement framework for Part B payments. Based on your performance in MIPS in 2017, your payments for Medicare Part B services will be adjusted up or down in 2019.

Your MIPS performance was scored across 3 categories for 2017:

  • Quality – Augusta Care Partners takes care of this reporting for you.
  • Improvement Activities – You automatically score 100% in this domain because you participate in an ACO.
  • Advancing Care Information – These “meaningful use” metrics were reported at the practice level. CMS then took all of our participating practice scores and created a weighted average score for this domain.

So… How did we do?

CMS initially scored our ACO at a 89.12, which resulted in a positive 1.42% payment adjustment; however, we did not believe that this score accurately represented how our providers performed in the Advancing Care Information domain. We filed a request for review in July 2018, and recently learned that our appeal was approved.

Our new MIPS score has increased to 96.6%, resulting in a positive Part B adjustment of 1.69% for all Augusta Care Partners practices.

Of note, our score was significantly higher than the mean and median scores of other Alternative Payment Models (APMs), resulting in a positive adjustment close to the maximum percentage possible:

Click here to view the full report on aggregated 2017 MIPS results from CMS.