As we mentioned in our recent MACRA related blog posts, the new Merit-based Incentive Payment Program (MIPS) will streamline the current patchwork of reporting programs into four performance categories (all under MIPS): Quality, Advancing Care Information, Clinical Practice Improvement Activities and Cost. Each of the categories
We’re going to take a deep dive into all four of the performance categories, one-by-one. Each of the four categories carry a percentage of the overall MIPS composite performance score (CPS) – and these weighted scores vary per category. We’ll begin our deep dive with the MIPS Quality Performance category, since it carries the most weight within the total MIPS CPS.
The Quality performance category replaces PQRS and the quality component of the Value Modifier Program, and it’s worth 50 percent of the MIPS total score in the first year of MACRA implementation.
Clinicians choose six measures versus the nine measures required under PQRS. For clinicians in solo practices or practices with up to nine clinicians, MIPS calculates two population measures based on claims data, which means they will have no additional reporting requirements for population measures placed upon them. When choosing six quality measures, clinicians will also choose one crosscutting measure related to patient outcomes or another high quality measures.
The idea is that clinicians will have reporting options to choose from to accommodate differences in specialty and practices. Clinicians choose one crosscutting measure, one outcome measure or another high quality measure (related to patient outcomes, appropriate use, patient safety, efficiency, patient experience or care coordination). There will be more than 200 measures and more than 80 percent of these are tailored for specialists. Clinicians can also opt to report a specialty measure set, specifically designed around certain conditions and specialty-types.
Next we will provide a list of pertinent measures in the Quality performance category, based on individual specialties.