greater potential to capture/analyze quality measures. Three categories of doctors will not be included in MIPS:
• Medicare Shared Savings Program tracks 2 and 3
•
Physicians in their first year of participation in Medicare
•
Physicians with low volumes of Medicare beneficiaries —
currently proposed is 100 patient thresholds for a physician
• Next Generation ACO mode
•
Doctors participating in an eligible APM, who qualify for that
bonus
Hospitals and facilities are not included in MIPS. This applies to
hospital-based physicians, such as pathologists and radiologists;
however, hospitalists will be included.
Alternative payment models have been in place now through
the Medicare Shared Savings Program (MSSP), administered by
several area Medicare accountable care organizations (ACOs).
Other models include one from the Center for Medicare & Medicaid Innovation (also known as the Innovation Center or CMMI),
bundled payments and the Pioneer ACOs. However, CMS is increasing the upside and downside risks for adva