The IT Implication of Merit-Based Incentive Payment System

January 09, 2019

Why more healthcare providers are outsourcing their information technology to medical IT companies

Currently, Merit-Based Incentive Payments Systems (MIPS) is the Center for Medicare and Medicaid Services’ (CMS) largest value-based care payment program and has been instrumental in turning the healthcare industry from a fee-for-service to pay-for-value. 


During 2017 and 2018, the following clinicians were subject to MIPS: MD/DO and DMD/DDS physicians, nurse practitioner, clinical nurse specialists, and certified registered nurse anesthetists. In 2019, that list has expanded to include the likes of physical and occupational therapists, speech-language pathologists, audiologists, clinical psychologists and registered dietitians. 


So, how does MIPS actually work, and how are healthcare providers adapting to the requirements of the system? 


Without getting too in-depth, MIPS looks at multiple factors when deciding a clinician’s score. For example, quality and cost make up 45 and 15 percent respectively of the overall score. 


While this type of payment system does help ensure that patients are being charged fairly, it is placing more constraints on hospitals and other healthcare facilities for keeping track of all these different measurements and data which is needed to calculate MIPS scores. Along with this, there are MIPS data submission and audit requirements from the CMS. 


“While most healthcare professionals agree that MIPS is a fair and smart payment system, it can be a handful to make sure that you are keeping up with the requirements that are necessary for the system”, says Chris Jann, CEO and Founder of , a healthcare information technology company, “We offer solutions that effectively address the need for these data submissions and allow our clients to focus on providing excellent care while we take care of the details,” continues Jann.


For reasons like the introduction of new payment systems, it makes sense for healthcare providers to outsource their IT. There are constant changes in healthcare regulatory laws (such as MIPS), and the industry overall now demands healthcare institutions to be more IT-savvy. As the venture capitalist and CEO of Google Ventures, Bill Maris, once said, with the passing of every year, it seems as though healthcare is becoming more and more a part of information technology. 


The healthcare providers and institutions that are teaming up with capable and experienced medical IT companies are positioning themselves for success for years to come. 


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