Higher 2023 MIPS Penalties is Good News
By Gary GerberJanuary 31, 2023
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.