American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

The One Action Necessary Now to Avoid the 4-Percent Medicare Payment Cut

As the year winds down, there still is ample time to avoid a 4-percent cut to your Medicare payments in 2019, based on your 2017 performance. With a few simple steps and less than 15 minutes of your time, you can avoid a 4-percent penalty even if you have not done anything until now to participate in the Merit-based Incentive Payment System (MIPS). 

The American College of Surgeons (ACS) hosted two webinars that provide the details needed to protect your Medicare payments. 

December 5 webinar

December 7 webinar

We have put together a series of videos to help you navigate the 2017 Merit-based Incentive Payment System (MIPS) program. (To view in fullscreen, press the play button and then click on the square in the bottom right corner of the video.)







QPP at a Glance

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 called for major changes in the physician payment system that will begin to go into effect in 2017. This new payment system—the QPP—continues to advance a policy goal of basing payment on value rather than on volume. There are two pathways for surgeons to participate in the QPP—the Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

About MIPS

Merit-Based Incentive Payment System (MIPS) is the default QPP pathway most physicians will (initially) participate in. Download the ACS presentation on MIPS.

MIPS 2017 ComponentsComponents

  • Quality component (formerly PQRS)
  • Advancing Care Information (ACI) component (formerly meaningful use)
  • Improvement Activities (IA) component
  • Cost


  • A single MIPS final score will factor in performance in the four categories on a 0 to 100 point scale.
  • Surgeons can receive positive or negative payment adjustments based on their final score (see diagram below).

How much can MIPS adjust payments?

MIPS Implementation Resources

Understanding the Program

Glossary of Acronyms and Terms

Fact Sheets

The Complete Briefing Book

PowerPoint Presentations from the 2017 Videos

About APMs

The ACS-Brandeis University Advanced Alternative Payment Model (APM) is currently under review by the U.S. Department of Health and Human Services (HHS). The ACS-Brandeis Advanced APM can be viewed on the HHS website.