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Clinicians’ MIPS scores include 30 points for MIPS Quality. For MIPS reporting, clinicians must provide at least six quality measures for the year. 70% data completion.

With the performance level raised to 75 points, avoiding penalty deductions requires a good quality score. MIPS success this year requires an effective and high-scoring Quality plan. Let’s examine some key elements any physician must include in their Quality approach.

Don’t overfill
A topped-out P3Care measure is one with a median performance score of 95% or higher, according to CMS. Many MIPS clinicians report top-performing metrics. CMS believes that continuous reporting of these parameters will neither yield useful quality data nor allow doctors to enhance patient care.

Even with a 100% performance rate, the CMS caps topped out measures at 7 points. Topped-out measures must be reported on all insurance patients like CQM (Registry) measures. MIPS removes topped-out measures after four years. After three years, a measure will be eliminated (4th year). Topped-out measures may be withdrawn sooner than 4 years.

If a physician reports six topped-out Quality criteria, the maximum score is 42 points, a 30% loss of points. With the minimum performance criterion set at 75 points this year, every point matters, and reporting topped-out measures is a hazardous strategy given how difficult MIPS has become. To maximize the Quality score, prefer 10-point standards above topped-out measurements.

Select efficient benchmarks

Quality measure benchmarks determine performance rate points. Quality scores 0-10 points. Diabetes Eye Exam and Colorectal Cancer Screening standards are examined.

100% performance for Diabetes Eye Exam earns 7 points, while 99% earns 4 points. 1% performance rate decreases points by 42%. Performance below 94.31% is worthless.

Colorectal Cancer Screening scores 10 points for 99.43% performance and 9 points for 99%. Performance below 17.93% is worthless.

For Diabetes Eye Exam, a modest performance rate decline results in a large score drop. Even a performance rate as high as 94% will generate no points, yet the rate yields 9 points for Colorectal Cancer Screening. This reveals that diabetes eye exams score poorly, with doctors losing points disproportionately when their performance rate drops. Avoid submitting Quality benchmarks like Diabetes Eye Exam this year.

Choose measures with the small patient population

Quality metrics demand a big patient population. For example, for Quality Measure Preventive Care and Screening Influenza Immunization, patients of the age of 6 months and greater of all genders must be reported. Breast Cancer Screening requires only female patients aged 51–74.

The patient population for Breast Cancer Screening is significantly less in contrast to Influenza Immunization. A measure with a limited patient population is easier for the reporting clinician and can still get 10 points.

Smaller patient populations reduce the risk of performance rate decline. A Quality measure has a performance met option which increases its performance rate, and performance not met option which decreases its performance rate. When data completeness has been met, the number of occasions performance not met has been reported diminishes its performance rate. A lower performance rate gives fewer points. Performance not met is less likely to be recorded for fewer patients. Breast Cancer Screening Quality ID #112 (NQF 2372) reporting choices.

when data completeness is fulfilled. However, reporting “Screening, diagnostic, film, digital or digital breast Tomosynthesis (3D) mammography data were not documented and examined, reason not otherwise mentioned” lowers performance.

When the practitioner doesn’t record a mammogram, Breast Cancer Screening performance is not met. Breast Cancer Screening might perform worse than Preventive Care and Screening Influenza Immunization if its patient population was the same. Patients with more encounters must be reported. Fewer patients mean fewer performance failures. This boosts performance and measure points.

Quality Measure 112’s performance rate increases

Prioritize smaller patient populations above larger ones. Clinicians can enhance their total score by focusing on other MIPS areas with less Quality work. Small practices qualified to report MIPS benefit from this because they can’t devote the time and staff like large practices to maximize their score. With less MIPS work, clinicians and practice staff can focus on improving patient care.

Clinicians must examine the three considerations above while choosing Quality measures for MIPS this year. A solid Quality approach will get clinicians maximum scores. This year, a high score can receive the biggest MIPS bonus payout ever.

CureMD’s MIPS consultants create and implement high-scoring Quality strategies. Reviewing measure specifications and benchmarks are daunting with approximately 200 Quality measures. With over a decade of expertise dealing with CMS incentive programs and in-depth knowledge of Quality measures, our advisors will get you the maximum Quality category points with little labor.

Tracking development is difficult. Our specialist will guide you all year. Clinicians are followed up often to ensure performance targets are met. Each follow-up includes thorough progress reports on the total Quality score, performance rate for each measure, verification data completeness, and a year-long Quality strategy. Our state-of-the-art MIPS dashboard gives our clinicians real-time MIPS progress reports throughout the year. With a 100% success rate and over 18,000 quality submissions, our consultants are professionals in maximizing Quality scores.