Skip to main content

Perfect MIPS Score Leads to Positive Medicare Reimbursement Adjustment for MaineHealth ACO Providers

August 30, 2019

CMS (Centers for Medicare and Medicaid Services) recently announced that participants in the MaineHealth ACO earned a perfect score of 100 for MIPS (the Merit-based Incentive Payment System) in 2018, resulting in a 1.68 percent increase in their Medicare Part B professional service reimbursement rate beginning in 2020. MIPS is a risk-based program that can result in either a negative or positive reimbursement adjustment, based on provider performance on utilization and quality measures.

“Securing a positive adjustment based on stellar performance is a tremendous result,” says Betsy Johnson, MD, MS, FACP, president and CEO of the MaineHealth ACO. “Increases in reimbursement can mean more resources for practices and their population health efforts, an outcome that the ACO welcomes. But of course, our perfect score represents more than a financial gain. It reflects providers’ and care teams’ sincere dedication to high quality care and suggests that more patients are getting the right care, at the right place at the right time. The performance of every provider in the ACO contributed to this score. They can be proud of what they achieved individually and what their ACO network of 1,600 providers achieved together.”

The MIPS score was determined by analyzing aggregated performance data in three categories: Quality, Clinical Practice Improvement Activities and Promoting Interoperability. By virtue of participation in the MaineHealth ACO, providers earned full credit in the improvement activities category and had their MSSP (Medicare Shared Saving Program) quality performance data automatically applied to the MIPS quality category.

Our performance highlights include a 30 percent increase in post-discharge medication reconciliation, a six percent increase in colorectal cancer screening and a high decile performance in diabetes control and tobacco intervention.

More information about MIPS is available on the provider resource page of the MaineHealth ACO website (www.mainehealthaco.org).

News from Around MaineHealth

View All
MaineHealth Earns 2020 CHIME Digital Health Most Wired Recognition
The CHIME Digital Health Most Wired program conducts an annual survey to assess how effectively healthcare organizations apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.
Credit rating agencies reaffirm strength of MaineHealth
Two credit rating agencies continued to give northern New England’s largest health system high marks for its financial strength even though the COVID-19 pandemic has had a significant financial impact.
MaineHealth Receives Over $800,000 in Federal Funding for Telehealth Program
FCC awarded MaineHealth for costs associated with rapidly expanding the health system’s telehealth infrastructure and technology in response to the coronavirus pandemic.
MaineHealth Welcomes Susan Ahern, Vice President of Innovation
MaineHealth is pleased to welcome Susan Ahern as Vice President of Innovation, a new systemwide role responsible for planning and development of the MaineHealth Innovation Center.
MaineHealth Accountable Care Organization taps chief operating officer to be its new president
Jennifer Moore has been a leader in the organization for more than 20 years.
Perfect MIPS Score Leads to Positive Medicare Reimbursement Adjustment for MaineHealth ACO Providers
CMS (Centers for Medicare and Medicaid Services) recently announced that participants in the MaineHealth ACO earned a perfect score of 100 for MIPS (the Merit-based Incentive Payment System) in 2018, resulting in a 1.68 percent increase in their Medicare Part B professional service reimbursement rate beginning in 2020.
MaineHealth Releases Annual Health Index Report
MaineHealth has released its ninth consecutive Health Index Report, an annual review of progress on seven high-priority population health issues that impact the health status of people and communities across the MaineHealth service area.
Brief ACO News (BACON) Podcast Series
BACON is Brief ACO News for providers participating in the MaineHealth Accountable Care Organization.
How One Small Practice Achieved All ACO Quality Goals
When Dr. Rob Merrill visited London not long ago, he noted all the “Mind the Gap” signs in the subway system reminding riders to look out for the space between the train and the platform. When he returned to his family medicine practice at PenBay,