Background/Purpose: Under the Medicare Access and CHIP Reauthorization Act (MACRA), rheumatologists face financial repercussions through the Merit-Based Incentive Payment System (MIPS) based on performance on quality measures and use of electronic health records (EHRs). For the MIPS 2017 reporting year (Jan. 1, 2017-Dec. 31, 2017), providers were scored across 3 domains: Quality, Improvement Activities (IA), and Advancing Care Information (ACI). In this study, we sought to evaluate MIPS performance for practices that reported through the ACR’s Rheumatology Informatics System for Effectiveness (RISE) registry.

Methods: The RISE registry continuously collects data from the EHRs of participating practices, allowing centralized aggregation and automated analysis of quality measures under the quality domain. RISE also allows providers to self-report on the other two domains that were active for 2017, IA and ACI. Using data from RISE, we calculated performance for all providers who reported for MIPS through the registry. We also evaluated the differences in performance on all three domains among providers who reported individually versus as part of a group.

Results: For the 2017 reporting year, 346 providers from 125 practices used the RISE registry to complete a total of 178 MIPS submissions for at least one domain, representing about 10% of MIPS-eligible rheumatology clinicians in the U.S. Most practices were either a group (47%) or solo practice (30%). Others were in some other clinical setting (5%), a health system (1%) or did not have practice setting information (18%). Of all submissions through RISE, 134 (76%) were considered full submissions on all 3 domains (Quality, IA and ACI). All full submissions exceeded the exceptional performance threshold of 70 points out of 100, earning all providers an additional bonus. While all rheumatologists submitting through RISE had high performance, those who submitted as part of a group had a slightly higher overall average performance (95.0 points) than those who submitted individually (92.1 points).

Conclusion: We found that all rheumatologists who completed full submissions through RISE were successful in the first year of MIPS, earning bonuses on their payment reimbursements for 2019. While some aspects of MIPS will be changing in 2018, RISE is continuously updated to track and maximize success in 3 of the 4 2018 MIPS domains. Further research is planned to investigate the workflows of group and solo practices who were top performers, as well as to assess the correlation between providers’ MIPS scores and their patients’ outcomes.

Disclaimer: This data was supported by the ACR’s RISE Registry. However, the views expressed represent those of the authors, not necessarily those of the ACR.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatologists-participating-in-the-rise-registry-succeeded-in-the-first-year-of-the-merit-based-incentive-payment-system-mips/