Get Started Now with MIPS in 2026 to Avoid Penalties
Updated: Aug 17
MIPS can feel like something to worry about later, until “later” becomes a missed reporting window and a Medicare payment penalty. The good news is simple: if 2026 is your performance year, there is still time to get organized, report accurately, and improve your score.
The Merit-based Incentive Payment System, or MIPS, rewards eligible clinicians who deliver high-quality, efficient care and meet reporting requirements under Medicare’s Quality Payment Program. The program may feel complex, but getting started does not require a perfect plan on day one. It requires a clear first step, a manageable focus, and consistent follow-through.
Why it is not too late to avoid MIPS penalties in 2026
MIPS performance is measured during the performance year, and payment adjustments usually apply later. That timing gives clinicians and practice teams room to improve before scores are finalized, especially if they act early in the year.
The largest mistake is waiting until the end of the year to look at measures, data completeness, or submission options. By then, gaps may be hard to fix. Starting now gives you time to:
Confirm whether you are required to participate
Choose measures that match the care you already provide
Review your data before it is submitted
Correct workflows that cause missing documentation
Track performance throughout the year
Under current MIPS rules, non-compliance can lead to a negative Medicare Part B payment adjustment. The exact impact depends on CMS rules for the year and your final score, but the risk is real enough to justify action now.
For many practices, the first win is not dramatic. It is simply moving from “we are not sure what we are reporting” to “we know our measures, owners, data source, and deadlines.”
Focus on the quality category first
MIPS includes several performance categories, including Quality, Cost, Improvement Activities, and Promoting Interoperability. Each matters, but the Quality category often deserves early attention because it connects directly to clinical documentation and patient care.
Quality measures evaluate care processes and outcomes. Depending on specialty and reporting method, these may involve preventive screenings, chronic disease management, medication safety, follow-up care, or patient outcomes.
A smart Quality strategy starts with fit. Do not pick measures only because they seem easy. Pick measures that reflect your patient population, your clinical strengths, and data you can actually capture.
For example, a primary care group that already tracks diabetes care may do better by improving documentation around hemoglobin A1c control than by selecting a measure that requires a brand-new workflow. A specialty practice may find better success through registry-supported measures designed for its field.
The goal is not just to report. The goal is to report measures you can improve.
Steps to begin the process immediately
Getting started with MIPS in 2026 is easier when the work is broken into small, practical moves.
1. Confirm your participation status
Start with the CMS Quality Payment Program participation lookup tool. Use your National Provider Identifier to check whether you are required to report MIPS, excluded, or participating through another path.
This step matters because participation can vary by clinician, group, specialty, volume, and payment model.
2. Identify your reporting method
Common reporting paths may include claims, electronic health record reporting, qualified registries, qualified clinical data registries, and group reporting. The right method depends on your specialty, technology, and available support.
Ask your EHR vendor or registry partner what they support for the 2026 performance year. Do not assume last year’s setup still works the same way.
3. Choose quality measures early
Select measures that are clinically relevant and realistic to track. Look at:
Patient volume for each measure
Documentation requirements
Data completeness expectations
Historical performance, if available
Whether the measure has benchmarks
If a measure depends on actions your team rarely performs or rarely documents, it may create avoidable risk.
4. Run a baseline report
Pull current-year data as soon as possible. Even a rough baseline can reveal missing fields, coding issues, or workflow gaps.
For example, one small internal medicine practice discovered that its care team was completing fall-risk assessments, but the result was often entered in a free-text note instead of the structured field needed for reporting. After a short training and template update, the data began to appear correctly in reports.
That kind of fix is much easier in March than in December.
5. Assign owners
MIPS fails when everyone assumes someone else is watching it. Give each part of the process a clear owner:
Task | Suggested owner |
Participation check | Practice manager or billing lead |
Measure selection | Clinician champion and quality lead |
EHR data review | EHR administrator or reporting lead |
Workflow training | Clinical manager |
Submission confirmation | Compliance or operations lead |
A small team can cover multiple roles. What matters is that every task has a name attached to it.
Build habits that improve quality performance
The best MIPS work happens inside normal care, not as a separate scramble at year-end. Once measures are selected, turn them into repeatable habits.
Try these practical changes:
Add measure prompts into visit templates
Use pre-visit planning for screenings or labs
Review open care gaps during huddles
Check measure performance monthly
Share simple progress updates with clinicians
Fix documentation issues as they appear
A midsize specialty group used this approach with registry reporting. Instead of waiting for year-end feedback, the group reviewed measure performance during regular quality check-ins. Clinicians saw where documentation was incomplete, staff corrected patient intake steps, and the registry data improved before submission time. The result was less stress and more confidence in the final report.
This is where the Quality category can become more than a requirement. It can help teams spot missed follow-ups, close care gaps, and make performance visible.
Reliable resources for MIPS guidance
MIPS rules can change from year to year, so use sources that reflect current CMS guidance. Good starting points include:
The CMS Quality Payment Program website
The QPP Participation Status Tool
CMS MIPS measure specifications and measure inventory
CMS fact sheets for the current performance year
Your specialty society’s MIPS resources
Your EHR vendor’s reporting documentation
Qualified registry or QCDR support teams
Medicare Administrative Contractor education pages
Specialty societies can be especially helpful because they often translate broad CMS rules into practical guidance for specific clinicians. A cardiology practice, orthopedic group, or behavioral health clinician may need very different measures and workflows.
When in doubt, compare advice against official CMS materials. Vendor support is useful, but CMS guidance should be the source of truth.
A simple 30-day MIPS starter plan
If MIPS feels overwhelming, use the next 30 days to build momentum.
Week 1
Confirm participation status, identify eligible clinicians, and gather last year’s reporting information if available.
Week 2
Choose a reporting method and shortlist quality measures that fit your specialty and available data.
Week 3
Run a baseline report, review missing data, and identify documentation gaps.
Week 4
Train the team on measure workflows, assign owners, and schedule monthly performance reviews.
This plan will not solve every issue, but it will move you from uncertainty to control. That shift alone can prevent costly mistakes.
Start now and make MIPS manageable
Get Started with MIPS in 2026 Avoid Penalties and Boost Quality Performance is more than a compliance reminder. It is a practical opportunity to reduce risk, strengthen reporting, and improve the way quality data supports patient care.
Start with participation status. Choose meaningful quality measures. Review your data early. Use trusted CMS and specialty resources. Then keep checking performance before small problems become year-end surprises.
The best time to begin is before the pressure builds. The second-best time is today.
Contact us today if you have any questions 803-205-2544
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