MIPS Tips (November)

Are you ready to finish strong? The Merit-based Incentive Payment System (MIPS) 2019 reporting year is now in its last few weeks.

Category Corner – Cost performance category of MIPS.
Although the Cost category is not tracked in CQR and is entirely claims-based, it is still important for providers to understand how it is scored as it accounts for 15% of the overall score in 2019. Reference the 2019 Cost Performance Category Fact Sheet for more information.

Program Perks – New and important updates from CMS on the Quality Payment Program.
CMS released the 2020 Final Rule on November 4, 2019, via a QPP Listserv announcement (reference the 2020 QPP Final Rule Fact Sheet for more information). 2020 QPP Final Rule Policy Highlights and key finalized policies for 2020 include:

  • Maintaining the weights of the Cost (15%) and Quality (45%) performance categories.
  • Increasing the performance threshold from 30 points to 45 points.
  • Increasing the data completeness threshold for the quality data that clinicians submit to 70%.
  • Increasing the Improvement Activity performance category participation threshold for group reporting from a single clinician to 50% of the clinicians in the practice.
  • Revising the specifications for the Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary (MSPB) Clinician measures.
  • Updating requirements for Qualified Clinical Data Registry (QCDR) measures and the services that third-party intermediaries must provide (beginning with the 2021 performance period).

Measurement Metrics – Specific measures and how to improve your scores.

  • Support Electronic Referral Loops by Receiving and Incorporating Health Information – this specific measure requires the Regulatory Hotfix: Click here for more information and to see if your practice needs to take action.
  • Security Risk Analysis – If you are not reporting the PI category of MIPS, you will not have to complete a Security Risk Analysis for 2019. We still recommend that a Security Risk Analysis be done annually to ensure HIPAA compliance.

Toolbox Tactics – Tips for how to use CQR, the Quality Reporting tool to manage and monitor your progress. 
Providers and administrators can find the CMS specifications for various measures or Improvement Activities for MIPS via CQR.

  • Promoting Interoperability Measures – Under the “Measure name” column, click the blue measure name (example, “Supporting Electronic Referral Loops by Sending Health Information” will take you directly to the CMS specification for the measure).
  • Quality Measures – Under the “CMS #” column, click the blue measure number (example, “CMS69,” and this will take you directly to the CMS guidance for the measure). Below the CMS guidance, it will outline how the measure is being calculated using athenaPractice and CQR for the Initial Patient Population, Denominator, Numerator, Exceptions and Exclusions.
  • Improvement Activity – under the “Activity ID” column, click the blue activity ID (example, “IA_PM_16,” and this will take you directly to the CMS definition of the Improvement Activity).

MIPS Consulting
Quatris Healthco offers quality consulting services to all of our customers. For information, contact mkeller@qhco.com. Note: The content of this email may not apply to your practice. Contact your EMR vendor on processes for support and quality reporting program.