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Performance Categories & Scoring

Quality

Advancing Care Information

Improvement Activities

Cost (Begins 2018)

The QUALITY component of the MIPS reporting program was intended to replace the former legacy program, the Physician Quality Reporting System (PQRS). Clinicians will be reporting in a similar fashion, on quality measures, either as individuals or groups. CMS has named 2017 the ‘Transition year’, where clinicians may choose their pace and submit their choice of data in order to avoid the negative payment adjustment.
The ADVANCING CARE INFORMATION category replaces the former Medicare EHR Incentive Program. It is designed to promote efficient care with the support of technology. The ACI category requires eligible clinicians to report on mandatory base score measures in order to receive credit. Clinicians are encouraged to report on performance as well as bonus score measures in order to maximize their scores.
The IMPROVEMENT ACTIVITIES category is brand new in the MIPS program, and was designed to promote engagement in clinical activities as well as improvement in the quality of care delivered. Eligible clinicians will choose a combination of various high and medium weighted activities in order to meet the requirements.

Quality - 60%

  • Must choose 6 measures to report, or a specialty measure set, for a minimum of 90 days
  • No domain requirements
  • Must choose AT LEAST 1 outcome measure.
    • If no outcome measure is applicable, must choose 1 high priority measure.
  • 243 registry measures to choose from
  • 50% Reporting threshold for 2017

  • Total points possible: 60-70 (group reporting)
  • Performance deciles range from 3 points to 10 points
  • Measures are scored relative to their benchmarks
  • If no benchmark exists for scoring, the measure will receive 3 points
  • Bonus points can be achieved through CAHPS and high priority measures
  • 0 points will be awarded for poor performance that falls below the first decile

parallax layer

Advancing Care Information - 25%

  • Required to use certified EHR technology (either 2014 or 2015)
  • Choose to report customizable measures to reflect how they use the technology
  • Must report on all base score measures (4 or 5, depending on CEHRT), for a minimum of 90 days
  • To maximize score, report on performance and bonus measures

  • Total points possible: 155 (any score above 100 will be capped at 100)
  • Base Score: 50, Performance Score: 90, Bonus Score: 15
  • 100% will equate to the full 25 MIPS percentage points
  • Reporting on all the required base score measures will award clinicians 50 points

The following clinicians are subject to an automatic re weighting for ACI:

  • Physician Assistants
  • Nurse Practitioners
  • Clinical Nurse Specialists
  • Certified registered nurse anesthetists
  • Clinicians who lack face-to-face interactions with patients

Improvement Activities - 15%

  • Attest by indicating “yes” or 1 patient, to each activity that meets the 90-day requirement
  • Select activities that match practice goals
  • Select a combination of high and medium weighted activities
  • 92 activities to choose from in 9 subcategories

  • Activities are categorized by weight as either ‘medium’ or ‘high
  • Patient Centered Medical Home practices will automatically receive full credit for this category

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