Higher 2023 MIPS Penalties is Good News

Prior to 2022, CMS has never penalized more than 3% of all providers. The rules have recently changed. CMS is now required to penalize everyone with below-average scores. In 2022, CMS estimates that approximately 33% of all providers will pay into the penalty pool. In 2023, the number increases to 38%.

Average scores will get tougher to achieve in 2023. The first five years of MACRA were structured to be easy. Many of those elements have gone away. Bonus points on Quality were eliminated in 2022 and the Exceptional Bonus Pool has been eliminated in 2023. Benchmarks continue to get tougher, and penalty thresholds are higher.

The good news is that the penalty pool is used to fund the payment pool. Radiologists who score above the penalty threshold can earn up to a 9% positive payment adjustment. In 2023, there is real money on the table for higher performing radiologists. However, most practices will need assistance to achieve higher MIPS scores.

Velocity MIPS Reporter uses AI to automatically analyze your data and determine MIPS scores. Our consultants host regular MACRA optimization sessions during the year to help your practice stay on track to optimize providers’ performance and maximize your Medicare payment adjustments.