MIPS Reporting Automation: Know Your Score Before CMS Does

The 2026 MIPS performance year runs January 1 through December 31, 2026. Your performance determines your 2028 Medicare payment adjustments — a two-year lag that makes real-time monitoring critical. You can't fix December with November data; you need to catch problems in February.

The maximum payment swing is ±9% on all Medicare Part B allowed charges. For a practice billing $1 million annually in Medicare, that's a $90,000 difference between optimal performance and a penalty. The typical approach — reviewing performance once at year-end — is the equivalent of checking your bank statement in December for the first time.

The annual data dump problem is real: practices receive a summary of their MIPS score months after performance year end, when nothing can be done about it. Vizier gives you rolling measure performance throughout the year — so you know in March whether you're on track for the Quality category, not in February of the following year.

PI Requirements and Exception Pathways

The Promoting Interoperability category requires certified EHR technology use and specific measure reporting. Hardship and reweighting exceptions are available for small practices, certain practice types, and organizations facing EHR transitions. Missing an available exception is leaving points on the table.

We review your PI eligibility status, identify applicable exceptions, and configure your Vizier tracking to reflect your actual reporting requirements — not a generic template that assumes every organization is identical.

40 Points Required (20 for Small Practices)

Improvement Activities require 40 points for standard practices — two medium-weight activities (20 points each) or one high-weight activity (40 points). Small practices, rural practices, and Health Professional Shortage Areas need only 20 points.

Most practices are already performing qualifying activities without documenting them. Telehealth expansion, care coordination programs, chronic disease management, and patient safety initiatives often qualify. We identify which of your existing workflows count before recommending anything new.

MIPS tracking in Vizier is not an annual report — it's a live dashboard that updates each time you upload encounter data. Your quality team sees composite score projections, category breakdowns, and individual measure performance in real time. When a measure drops below threshold in April, you have eight months to recover it.

The submission-ready export means your quality team spends 15 minutes per week reviewing performance, not 15 hours per month compiling spreadsheets. The data is formatted for your registry or CMS Web Interface submission — we don't just give you numbers; we give you the numbers in the format the submission requires.

MIPS setup in Vizier takes three weeks from initial data access to first automated score calculation. The sooner in the performance year you start, the more time you have to course-correct. Starting in Q1 gives you 9 months to fix problem measures; starting in Q4 gives you nothing.