Exhibit 1. Distribution of MIPS composite scores & Payment Adjustments.

Source: Authors’ analysis of 2017 MIPS performance data from CMS Physician Compare database.

Notes: In the first year of MIPS, clinicians reporting below the performance threshold of 3 received negative payment adjustments to Medicare Part B reimbursements. Those reporting a score of exactly 3 received a neutral adjustment, while those between 3 and 70 received positive adjustments. Any provider scoring over 70 was eligible for a share of a $500 million “exceptional performance” bonus payment adjustment. In 2017, the maximum positive payment adjustment a clinician could obtain was 1.88 percent.⁴ High observed frequencies at 15 points were achieved by clinicians achieving the maximum points in Improvement Activities (IA) but not participating in Quality or Advancing Care Information (ACI), and the high frequency at 40 points was due to clinicians achieving the maximum in IA and ACI but not participating in the Quality component.