Healthcare Insights

Top 25 Physician Groups by MIPS and Medicare Payments

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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.

Top 25 Physician Groups by MIPS Score and Medicare Payments:

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Physician Group NameDefinitive IDMIPS ScoreTotal Medicare PaymentsNumber of Medicare ProceduresExplore This Dataset
1.NYC University Physicians Network577713100%$203,431,6645,055,819Explore This Profile
2.Aurora Health Care Medical Group Inc550238100%$186,348,9095,076,502Explore This Profile
3.John Muir Health Physician Network550477100%$169,846,3075,439,559Explore This Profile
4.Beaumont Medical Group752078100%$153,365,9264,453,224Explore This Profile
5.Palo Alto Medical Foundation550513100%$147,569,9054,729,815Explore This Profile
6.Atrium Health Medical Group550275100%$146,544,4404,252,642Explore This Profile
7.Geisinger Clinic Physician Group550339100%$135,424,8163,005,014Explore This Profile
8.Northern Light Health Physicians622159100%$118,648,3193,308,725Explore This Profile
9.Santa Clara County IPA550734100%$116,908,3132,692,611Explore This Profile
10.Our Lady of the Lake Physician Group550741100%$111,984,1963,084,917Explore This Profile
11.Northwestern Medical Group552709100%$104,271,6772,690,496Explore This Profile
12.Sentara Medical Group550585100%$102,232,8981,940,907Explore This Profile
13.St Lukes Physician Group550612100%$100,714,6281,968,248Explore This Profile
14.Centra Medical Group550281100%$95,583,9663,005,491Explore This Profile
15.Sutter Medical Foundation550623100%$90,165,2522,769,055Explore This Profile
16.University of Washington Physicians551153100%$82,532,5631,451,514Explore This Profile
17.WillsEyePhysicians Mid Atlantic Retina638563100%$81,610,179364,827Explore This Profile
18.Deaconess Clinic645915100%$76,832,3911,941,662Explore This Profile
19.Intermountain Healthcare Medical Group618527100%$74,536,3942,664,754Explore This Profile
20.Prisma Health Physicians735848100%$72,793,2961,757,955Explore This Profile
21.University of Colorado Medicine550933100%$72,646,4791,348,385Explore This Profile
22.Valley Physician Enterprise763733100%$70,402,5451,865,333Explore This Profile
23.SSM Health Dean Medical Group550314100%$69,111,9552,668,782Explore This Profile
24.Baptist Medical Group550246100%$65,295,3802,742,496Explore This Profile
25.Sanford Health Medical Group550880100%$62,297,8861,594,713Explore 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.