Maximizing Incentives Under MIPS
The Merit-Based Incentive Payment System (MIPS) offers an important opportunity for medical practices to enhance their Medicare reimbursements. But achieving top-tier performance isn't accidental — it requires strategic planning, focused execution, and an ongoing commitment to excellence. In this guide, we break down how MIPS incentives work in 2025, proven strategies to maximize your score, and how Access1 can help your practice capture the full benefits.
Losing Revenue? Falling Behind on Compliance? Here’s What Smart Practices Are Doing
How the MIPS Incentive System Works in 2025
MIPS rewards or penalizes Medicare reimbursements based on a provider’s final Composite Performance Score (CPS). For 2025, practices must achieve at least 75 points to avoid penalties. Top-performing practices may earn payment bonuses up to 9%, depending on national performance. The category weights remain critical: Quality counts for 30%, Cost accounts for 30%, Promoting Interoperability represents 25%, and Improvement Activities cover the remaining 15%. Understanding these thresholds and weights is essential to maximize incentives and minimize risks.
Strategies to Maximize Your MIPS Score
Focus on High-Impact Quality Measures
Choosing the right quality measures is crucial. Practices should select measures that align with their specialty and patient population (e.g., Primary Care, Oncology, Cardiology), prioritize measures with strong benchmarks and historical performance, and ensure consistent reporting with data completeness rates of at least 75%.
Manage Costs Proactively
Cost management is more important than ever. Practices should analyze historical spending data to identify savings opportunities (such as reducing unnecessary tests or hospitalizations), implement care coordination programs to streamline treatment, and invest in chronic condition management initiatives to lower long-term expenses.
Boost Promoting Interoperability Scores
Technology optimization directly impacts MIPS scores. Practices must ensure their EHR systems are certified for 2025 (meaning full support for secure messaging, clinical data exchange, and patient portal access). Regular use of e-prescribing and clinical reconciliation tools further strengthens the Promoting Interoperability category.
Prioritize High-Value Improvement Activities
Selecting and documenting the right Improvement Activities is a smart way to earn additional points. Practices should focus on initiatives that improve patient outcomes and operational efficiency (like promoting digital health tools, screening for Social Determinants of Health, and enhancing chronic care management programs). All activities must be carefully documented to maximize audit-readiness.
Common Pitfalls That Hurt Your Incentives
Incomplete Reporting: Missing or inaccurate data submissions can significantly lower a final score.
Poor Measure Selection: Choosing low-volume or irrelevant quality measures may limit scoring opportunities.
Neglecting Documentation: Without clear evidence of completed Improvement Activities, practices risk losing crucial points.
Ignoring Cost Management: High costs can offset strong quality scores if not proactively addressed.
Partnering with Access1 to Maximize Your Reimbursements
Access1 specializes in turning MIPS challenges into financial opportunities. Our approach focuses on customized quality measure selection (tailored to your specialty and goals), proactive coaching to elevate performance across all categories, advanced revenue cycle management to strengthen financial health, and smart technology solutions that streamline data reporting, cybersecurity, and compliance.
Ready to Maximize Your MIPS Incentives?
Don't leave your 2025 reimbursements to chance. Get strategic, stay compliant, and maximize your success.
Learn how smart practices overcome revenue and compliance challenges
Ready to take control of your MIPS performance and maximize your incentives? Partner with Access1 for proven strategies, expert support, and real results.
Contact us today to get started.
