The Merit-based Incentive Payment System (MIPS) program was first implemented in 2017 to help identify where physicians are struggling and may require assistance. The program was designed by CMS to update and consolidate previous programs such as Physician Quality Reporting System (PQRS,) Value-Based Payment Modifier (VBM,) and the Medicare Electronic Health Records (EHR) Incentive Program for Eligible Clinicians. As the only publicly available Physician Quality Dataset, MIPS provides performance-based adjustments (positive or negative) to participating clinicians.
Over the course of 2018 and 2019, MIPS reporting requirements, eligibility, and participation guidelines have continued to evolve. Currently performance in the program is measured in four areas—quality, improvement activities, promoting interoperability (formerly ACI – Advancing Care Information) and cost. These four areas make up a final score which determines a clinician’s payment adjustment.
The following list includes the top Physician Groups that received a perfect MIPS score ranked by highest Medicare payment. Of the groups appearing on the list, California has the highest frequency with four groups in the top 25. The specialty with the highest frequency of appearance was family practice with 11 occurrences followed by internal medicine with nine occurrences.
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Physician Group Name | Definitive ID | MIPS Score | Total Medicare Payments | Number of Medicare Procedures | Explore This Dataset | |
1. | NYC University Physicians Network | 577713 | 100% | $203,431,664 | 5,055,819 | Explore This Profile |
2. | Aurora Health Care Medical Group Inc | 550238 | 100% | $186,348,909 | 5,076,502 | Explore This Profile |
3. | John Muir Health Physician Network | 550477 | 100% | $169,846,307 | 5,439,559 | Explore This Profile |
4. | Beaumont Medical Group | 752078 | 100% | $153,365,926 | 4,453,224 | Explore This Profile |
5. | Palo Alto Medical Foundation | 550513 | 100% | $147,569,905 | 4,729,815 | Explore This Profile |
6. | Atrium Health Medical Group | 550275 | 100% | $146,544,440 | 4,252,642 | Explore This Profile |
7. | Geisinger Clinic Physician Group | 550339 | 100% | $135,424,816 | 3,005,014 | Explore This Profile |
8. | Northern Light Health Physicians | 622159 | 100% | $118,648,319 | 3,308,725 | Explore This Profile |
9. | Santa Clara County IPA | 550734 | 100% | $116,908,313 | 2,692,611 | Explore This Profile |
10. | Our Lady of the Lake Physician Group | 550741 | 100% | $111,984,196 | 3,084,917 | Explore This Profile |
11. | Northwestern Medical Group | 552709 | 100% | $104,271,677 | 2,690,496 | Explore This Profile |
12. | Sentara Medical Group | 550585 | 100% | $102,232,898 | 1,940,907 | Explore This Profile |
13. | St Lukes Physician Group | 550612 | 100% | $100,714,628 | 1,968,248 | Explore This Profile |
14. | Centra Medical Group | 550281 | 100% | $95,583,966 | 3,005,491 | Explore This Profile |
15. | Sutter Medical Foundation | 550623 | 100% | $90,165,252 | 2,769,055 | Explore This Profile |
16. | University of Washington Physicians | 551153 | 100% | $82,532,563 | 1,451,514 | Explore This Profile |
17. | WillsEyePhysicians Mid Atlantic Retina | 638563 | 100% | $81,610,179 | 364,827 | Explore This Profile |
18. | Deaconess Clinic | 645915 | 100% | $76,832,391 | 1,941,662 | Explore This Profile |
19. | Intermountain Healthcare Medical Group | 618527 | 100% | $74,536,394 | 2,664,754 | Explore This Profile |
20. | Prisma Health Physicians | 735848 | 100% | $72,793,296 | 1,757,955 | Explore This Profile |
21. | University of Colorado Medicine | 550933 | 100% | $72,646,479 | 1,348,385 | Explore This Profile |
22. | Valley Physician Enterprise | 763733 | 100% | $70,402,545 | 1,865,333 | Explore This Profile |
23. | SSM Health Dean Medical Group | 550314 | 100% | $69,111,955 | 2,668,782 | Explore This Profile |
24. | Baptist Medical Group | 550246 | 100% | $65,295,380 | 2,742,496 | Explore This Profile |
25. | Sanford Health Medical Group | 550880 | 100% | $62,297,886 | 1,594,713 | Explore This Profile |
Fig 1. Program Year 2017 MIPS Performance Data was released as part of the July 2019 Physician Compare Update. The anticipated release date for MIPS Program Year 2018 data has not yet been released. Medicare data is from the Centers for Medicare and Medicaid Services (CMS) Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (PUF). Calendar Year data is projected to be released each July by the CMS. The most recent data is from calendar year 2017; 2018 data is scheduled to be released in July 2020.