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MIPS Category Weights

2017 VS. 2018

MIPS2017MIPS2018

Performance is measured through the data clinicians report in four areas - Quality, Improvement Activities, Promoting Interoperability (formerly Advancing Care Information), and Cost. MIPS was designed to update and consolidate previous programs, including: Medicare Electronic Health Records (EHR) Incentive Program for Eligible Clinicians, Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VBM).

The 2018 QPP Final Rule introduced Cost this year at 10%, so CMS is decreasing Quality’s weight to 50% to compensate. The PI and IA categories will remain at 25% and 15%, respectively.


Quality Measures

Category is Worth 50% of total MIPS score

Data Completeness:Submitted Quality measures must contain at least 60% of all Eligible Clinician patients across all payers.

Participants must submit data for at least 6 measures for the 12-month performance period (January 1 - December 31, 2018).

Participants should:

  • Submit collected data for at least 6 measures
  • One of these measures should be an outcome measure; if you have no applicable outcome measure, you can submit a high priority measure instead

Quality measure bonus points can be earned in the following ways:

  • Submission of 2 or more outcome or high priority quality measures (bonus will not be awarded for the first outcome or high priority quality measure)
  • Submission using End-to-End Electronic Reporting, with quality data directly reported from an EHR to a qualified registry, QCDR, or via CMS Web Interface
  • View the list of Quality Measures: Explore Quality Measures

Promoting Interoperability
(Formerly Advancing Care Information)

Category is Worth 25% of total MIPS score

CMS is re-naming the Advancing Care Information performance category to Promoting Interoperability (PI) to focus on patient engagement and the electronic exchange of health information using certified electronic health record technology (CEHRT). This performance category replaced the Medicare EHR Incentive Program for EPs, commonly known as Meaningful Use. This is done by proactively sharing information with other clinicians or the patient in a comprehensive manner. This may include: sharing test results, visit summaries, and therapeutic plans with the patient and other facilities to coordinate care.

  • Clinicians will be required to use certified EHR technology and will choose to report customizable measures that reflect how they use technology in their day-to-day practice. Unlike the existing reporting program, this category will not require all-or-nothing EHR measurement or duplicative quality reporting.
  • Submit the performance period (a minimum of 90 consecutive days period in 2018.
  • Bonuses available for registry reporting.
  • You may earn a maximum score of up to 165%, but any score above 100% will be capped at 100%.
  • The PI(Advancing Care Information) score is the sum of these 3 scores (50% Required Base score,up to 90% Performance score,up to 25% Bonus score)
  • Visit the list of PI(Advancing Care Information) measures: Explore PI(Advancing Care Information) Measures

Improvement Activities

Category is Worth 15% of total MIPS score

This is a new performance category that includes an inventory of activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care. The inventory allows you choose the activities appropriate to your practice from categories such as, activities focused on care coordination, beneficiary engagement, and patient safety (e.g.,expanded practice access, such as same-day appointments for urgent needs).  

To earn full credit in this category, participants must submit one of the following combinations of activities (each activity must be performed for 90 days or more during 2018):

  • 2 high-weighted activities
  • 1 high-weighted activity and 2 medium-weighted activities
  • At least 4 medium-weighted activities
  • View the list of Improvement Activity measures: Explore Improvement Activites Measures

COST

Category is Worth 10% of total MIPS score

This performance category replaces the VBM. The cost of the care you provide will be calculated by CMS based on your Medicare claims. MIPS uses cost measures to gauge the total cost of care during the year or during a hospital stay. Beginning in 2018, this performance category will count towards your MIPS final score.