Check your practice for overutilization before MIPS starts charging you for it

Why This Topic Matters

Understanding overutilization is important because low-value services can raise costs and may affect performance under value-based reimbursement programs. The article helps practices see why reviewing ordering habits, utilization patterns, and communication around necessity can be relevant to future MIPS scoring.

Article Sections

1. Quality Payment Program

   Introduces the broader payment context and explains why utilization patterns are drawing attention under the Quality Payment Program.

2. Prep for MIPS

   Discusses how cost and resource use fit into MIPS and why practices may want to examine inefficient service patterns in advance.

3. Check yourself

   Describes the use of expert recommendations and internal review methods as a way to evaluate potentially wasteful care.

4. Talk to your patients

   Focuses on communication with patients when services are deferred or limited and the need to explain care choices clearly.