Sightview's Holly Black on why the practices that finish strong in MIPS are the ones that stop waiting for year-end to care.
MIPS has a way of sitting quietly in the background until it suddenly becomes urgent. For busy eye care practices, the first half of the year can disappear into patient volume, staffing challenges, documentation demands, and day-to-day operational fires. But by midyear, your MIPS performance is already taking shape.
That is why Holly Black, Sightview Compliance Product Manager, recommends using this point in the year to pause, review performance, and make practical course corrections while there is still time.
The goal is not to make MIPS feel like another burden. It is to make sure the work your team is already doing is being captured correctly, measured consistently, and reported in a way that reflects the care being delivered.
Why midyear matters for MIPS
MIPS is not built for a last-minute save.
For traditional MIPS quality reporting, CMS requires eligible clinicians to report six quality measures, including one outcome or high-priority measure, or report a complete specialty set. Practices must collect and submit quality data for the full 12-month performance period, typically from January 1 through December 31.
This full-year requirement is exactly why midyear review matters. If a measure is lagging now, there may still be time to understand what is happening and fix it. Maybe the clinical action is happening, but it is being documented in the wrong place. Maybe staff are missing a workflow step. Maybe a registry mapping issue is preventing completed work from counting correctly. Holly’s guidance is simple: review quality dashboards now and address workflow or mapping problems while performance can still improve.
The mistake practices make too often
One of the biggest MIPS mistakes is waiting until the end of the year to ask, “How are we doing?”
By then, the data already tells a story the practice cannot change. Instead, midyear is the time to ask better questions:
If the answer is unclear, that is the signal to act now.
Promoting Interoperability needs a plan, not assumptions
Promoting Interoperability is another area where practices can lose ground if they wait too long. CMS states that the Promoting Interoperability category focuses on electronic prescribing, health information exchange, provider-to-patient exchange, public health and clinical data exchange, and protecting patient health information. It counts as 25% of the traditional MIPS final score unless reweighting or exceptions apply.
CMS also requires practices to collect Promoting Interoperability data in certified EHR technology for a minimum of 180 continuous days during the calendar year. Holly notes that July 1 is the practical deadline practices should keep in mind if they want to begin a full 180-day reporting period.
In other words, this is not a category to “figure out later.” Practices should know which measures apply, whether exclusions are available, who owns each workflow and whether required attestations are being handled with enough lead time.
Provider eligibility can change, so check it twice
Another easy miss: assuming provider eligibility is already settled.
Holly recommends reviewing each provider’s MIPS reporting eligibility now and again later in the year because eligibility can change during the performance period. CMS evaluates MIPS eligibility using Medicare Part B claims and PECOS data across two 12-month segments, and eligibility is reviewed at the both the TIN and NPI level.
That matters for practices with new clinicians, changing provider rosters, multiple locations, or providers billing under more than one TIN. A midyear eligibility review can help prevent surprises when it is time to report.
90 days goes faster than you think — here's your window
Improvement Activities can be manageable when practices choose activities that align with work already happening inside the organization. CMS describes this category as focused on clinical practice improvement, care delivery, patient engagement, care coordination, patient safety, and related areas of care.
For traditional MIPS, Improvement Activities require a minimum continuous 90-day performance period. CMS notes that the last continuous 90-day period for 2026 begins October 3. Holly recommends reviewing options now, selecting the activities your practice plans to report, and making sure documentation is being captured along the way.
The best Improvement Activity is not always the one that sounds most impressive. It is the one your practice can perform, document, and support if reviewed.
A quick midyear MIPS checklist
Before the year gets away from you, review:
If your team is unsure about any of these, midyear is the right time to find out.
MIPS performance is built in the margins of every patient encounter, every documented workflow, every measure that gets captured correctly or quietly falls through the cracks. Midyear is the moment when the gap between "we think we're on track" and "we know we're on track" still has time to close.
Ophthalmology practices that finish strong don't find out they were ready at year-end. They made sure of it in July. If the gaps we discussed sound familiar to you, the underlying issue is often the same: systems and workflows that weren't built with MIPS in mind.
Explore how connected EHR, practice management, reporting, and specialty-specific services come together at Sightview Ophthalmology.