ATI Physical Therapy recently announced its fifth consecutive year, earning an “Exceptional” rating from the Center for Medicare and Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS). The rating is a testament to the entire organization’s dedication to providing quality patient care while achieving its purpose of making every life an active life. However, the MIPS rating is more than accolades for clinicians. It was designed to reward Medicare providers for high-quality patient care and outcomes with the aim of lowering healthcare costs. 

The History of MIPS 

The Merit-Based Incentive Payment System was established in January 2017 as a way to consolidate and streamline legacy Medicare quality reporting programs. With MIPS, there is a reduced administrative burden, and clinicians obtain a greater certainty of reimbursement. Under the Merit-Based Incentive Payment System, providers are incentivized to avoid unnecessary tests and treatments, which theoretically leads to lower healthcare spending. 

MIPS assesses clinician services in four categories: 

• Quality: This category measures healthcare-related processes, outcomes, and patient experiences. Quality outcomes are 50% of the final score.  

• Improvement Activity: Determines the engagement in activities that support the improvement of clinical practice, care delivery, and outcomes. Improvement activity accounts for 15% of the final MIPS score, with the exception of smaller practices. 

• Interoperability:  Measures the ability to connect, communicate, exchange, and use information across different systems to optimize health outcomes. 

• Cost: Assesses Medicare payments made for care provided for patients and has a weight of 30% in the MIPS final score.  

Providers receive an annual score between 0 and 100. This score affects payments the provider receives in two years. For example, the 2024 calendar year score impacts provider payments in 2026. 

MIPS Impact for the Patient and the Provider 

What does all this mean for the patient? A provider’s MIPS score impacts the location and the scope of services available to patients. It also indicates the level of quality care a patient will receive from a given provider.  

For ATI, this means leveraging its proprietary electronic medical record and Patient Outcomes Registry™, which comprises more than 10 million patient-reported outcomes across 4 million patient episodes and 3 million unique patients. These components are vital to ATI’s commitment to improving quality care and health outcomes while reducing healthcare costs. 

“This annual recognition is a testament to our exceptional team of clinicians and the work they do daily. Physical therapy plays a critical role in the musculoskeletal health ecosystem (MSK), and we will continue to promote the value it has in helping our patients live pain-free lives,” said Charles Thigpen, Senior Vice President for Clinical Excellence, ATI Physical Therapy. “Levering our outcomes, experience, and single-branded platform, we strive to deliver differentiated care that reduces the cost of MSK as well as unnecessary opioids, imaging, or surgery.”