MIPS: 2017 Performance Scoring

January 27, 2017

Written by Sarah Leake

MACRA/MIPs will be scored based on four domains: Quality, Advancing Care Information, Improvement Activities, and Cost. Final scores are calculated on a 100 point scale. The table below from CMS provides a breakdown of the score to payment adjustment relationship. Eligible clinicians only need to have 3 points to avoid the payment adjustment.

Each domain carries a different weight, which can vary based on unique circumstances, but for most, scoring will apply as noted for the category.

Quality – the quality domain accounts for 60% of your overall MIPs score. It will also replace PQRS and transition Eligible Clinicians from Pay-for-Reporting to Clinician Performance in relation to benchmarks. In the transition to Clinician Performance, it has become easier to participate; only requiring Eligible Clinicians to select and report on 6 of over 300 available measures. Please note that one of the measures you select must be either a “High Priority” or “Outcome” based measure.

Advancing Care Information (ACI) – the ACI domain accounts for 25% of your overall MIPs score. ACI is similar to the previous EHR incentive program, Meaningful Use. CMS has base the new ACI measures on those found in Meaningful Use. One of the major requirements is that you utilize a CMS Certified Electronic Health Record Technology (CEHRT). Though ACI accounts for 25% of the total score, there are some complexities in how this portion is calculated. You may earn up to 155% of your ACI score (which accounts for 25% of your MIPs score), but even if you earn above 100% of the points you may only receive a total of 25% toward your total score. The score breaks down as follows:

• 50% comes from your base score.
• 90% from your performance score.
• You may receive up 15% of your score from bonus activities two ways:
• 5% for reporting additional Public Health measures and Clinical Data Registry Reporting measures.
• 10% for using CEHRT to complete certain activities from the Improvement Activities domain.

Just to reiterate, even if you earn 155% ACI score, you will still only receive 25% toward your total MIPs score.

Improvement Activities (IA) – Improvement Activities is a new domain where Eligible Clinicians are rewarded for activities that improve care provided. There are 90+ activities from 9 subcategories, each carrying one of two weights, heavy (worth 2 points) and medium (worth 1 point). To receive full credit, participants must attest for their selected activities for 90 days. Physicians in groups of 15 or greater must have 4 points from activities to receive full credit. Physicians in groups of less than 15 must have 2 points. Providers in patient-centered medical homes, certain specialty practice types, or those in an Alternative Payment Model labeled as a medical home model automatically receive full credit for this domain.

Cost – For 2017 the cost domain will not be counted toward your overall MIPs score. . Be aware that this may change for future years. There is no data collection necessary as CMS will assess cost based on claims data

Post contributed by Preston Groogan, QIO, Mountain-Pacific in Alaska

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