MIPS Reporting & Strategy from a CMS-Approved Registry
Get the MIPS score your care has earned.
Our CMS-approved registry picks the measures that score best for your specialty, tracks your score all year, and submits to CMS for you, including specialty measures most EHRs don't offer.
- 2026 reporting due
- March 31, 2027
- Penalty to bonus, one client
- $850K swing
A few points on your MIPS score can be worth six figures.
What your MIPS score is worth, in dollars
Example: a practice that bills Medicare $2 million a year
Its MIPS score for 2026 sets its Medicare payments in 2028. Here is what four different scores would mean.
- Score 100
- +$21,000A perfect score earns a bonus of about 1%
- Score 75
- $0The threshold: no penalty, no bonus
- Score 50
- −$80,000Below 75, the penalty grows on a sliding scale
- Score 18.75 or less
- −$180,000The maximum penalty: 9% of Medicare payments
The line on each scale marks 75, the score needed to avoid a penalty.
In the 2026 payment year, a perfect score earned +1.05%, the smallest bonus in program history. 27% of small practices were penalized in the 2024 payment year.
Most MIPS penalties trace back to the same four problems.
Four ways good practices lose points
Topped-out measures cap your points
A perfect 100% on a topped-out measure earns only 7 of 10 points. The measures you pick matter as much as the care.
Cost is scored from claims you never see
Cost is 30% of your score, calculated by CMS from claims. The median cost score is 42%, and most clinicians below it don't know why.
Benchmarks reset every January
Last year's winning measure mix can quietly lose points this year, and the first you hear of it is your payment adjustment.
Most registries only transmit
If the data they get is incomplete, they send a low score, and nobody warns you before it happens.
Every one of them can be fixed before the year closes. This is how we do it.
We run MIPS like the financial decision it is
- 1
Review last year's feedback report
We show you the points you left on the table, and what they were worth. - 2
Pick the measures that score best
We select the quality measures that score highest for your patient mix, including specialty measures most EHRs don't offer. - 3
Track all four categories, all year
Quality, cost, improvement activities, and promoting interoperability, scored the way CMS will score them, so nothing is a surprise. - 4
Model before you commit
Swap a measure or close a gap and see the point and dollar impact first. - 5
Submit, with a defense
We submit directly to CMS through our registry, with patient-level evidence behind every number. If CMS asks questions, we answer them.
Of those five steps, the measures you report move your score the most.
Specialty measures your EHR doesn't offer
4
Quality measures of our own, approved by CMS
Alongside the full 2026 MIPS measure set, each with its specification and benchmarks where CMS publishes them.
Find the measures for your specialty
Each page lists the measures available for that specialty, with their benchmarks.
- Cardiology
- Orthopedic surgery
- Nephrology
- Gastroenterology
- Dermatology
- Neurology
- Internal medicine
- Family medicine
Choosing the right measures changes the result. Three examples.
What changed when practices switched their reporting to us
- $850KPain management practicePenalized for years because their EMR only offered generic measures. We reported specialty measures from data already in their charts.
- $250KOrthopedic surgery groupRecovered by switching from generic to specialty measures.
- 148%Community practiceHigher score after leaving a manual reporting vendor.
- quality reporting tier, across our clients
- Top 1%
- lost to non-compliance under our management
- $0
- audit failures, ever
- 0
- client retention across more than 100 practices in 12+ states
- 96%
MIPS questions we hear every week
Read the 2026 MIPS guideWhat does a low MIPS score cost?
Up to 9% of your Medicare Part B payments, applied two years after the performance year. On $2 million a year in Medicare revenue, that is $180,000.
How big is the bonus for a perfect score?
Small. Bonuses are paid out of penalties, so they are budget-neutral by law. In the 2026 payment year, a perfect score earned 1.05%, the smallest in the program's history.
What is a QCDR?
A Qualified Clinical Data Registry is an organization approved by CMS to collect and submit MIPS data, and to offer its own quality measures. VBCA is one, with 4 CMS-approved measures of our own.
My EHR doesn't offer good measures for my specialty. What can I do?
That is the most common reason specialists score poorly. We report specialty measures through our registry, often from data that is already in your charts.
When is 2026 MIPS reporting due?
The submission window closes March 31, 2027. We submit for our registry clients and aim to finish in February.
Should my practice join an ACO instead?
If you are an independent practice billing Medicare, it is worth comparing. Our ACO pays incentives above and beyond MIPS: shared savings, care management revenue, and the office-visit bonus. We compare both on your call.
Send us last year's feedback report
Get a score review
Or email Support@VBCA.com