Radiology groups face hardships under the Medicare MIPS program
Erik Rockswold, MHA, MA, director of research and quality measures, Rayus Radiology, explains the administrative burdens radiology groups are facing with the Medicare Merit-based Incentive Payment System (MIPS) and possible solutions on the horizon. He spoke with Radiology Business at the Radiology Business Management Association (RBMA) 2025 meeting.
"For a long time MIPS has been an administrative burden, and the penalties are getting bigger, now at 9% potentially if you do not file or do very poorly on your MIPS Medicare Part B physician payments," Rockswold explained. "The bonuses are also getting smaller and smaller. Initially you might have been promised up to a 9% bonus, but now if you score perfectly on MIPS, you might get a a 2%–2.25% bonus. But for the amount of administrative burden and the time they are putting into this, people are seeing this as a lot of work for nothing."
He said practices are often doing MIPS as a defensive action to prevent further erosion of their payments, with little left afterward due to the high administrative costs involved. He said MIPS and bonus reductions are on top of the annual reductions in the Medicare Physician Fee Schedule.
Radiology has the deck stacked against it in terms of MIPS because there are not many quality measures specific to the speciality, or the lack of benchmarks leads to a big disadvantage, he said.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.