MIPs

QUALITY


(replaces PQRS)

This category covers the quality of the care you deliver, based on performance measures created by CMS, as well as medical professional and stakeholder groups. You pick the 6 measures of performance that best fit your practice. 1 of the 6 must be an outcome measure or high-priority measure. Full year reporting though: QCDR, Claims, Qualified Registry, EHR, CMS Web Interface, or CAHPS Survey

IMPROVEMENT ACTIVITES


Attest that you completed up to 4 improvement activities for a minimum of consecutive 90 days
  • Combination choices:
    • 2 high-weighted activities
    • 1 high-weighted and 2 medium-weighted activities
    • 4 medium-weighted activities
  • IAs available increased from 92 to 112 for 2018.
  • Participants in certified patient-centered medical homes, comparable specialty practices or an APM designated as a Medical Home Model (PCMH) will earn full credit. You have the option to attest to being a PCMH under Improvement Activities. Note, there is a 50 percent threshold for 2018 for the number of practice sites within a taxpayer identification number (TIN) that need to be patient-centered medical homes for that TIN to get full credit for the IA category.

ADVANCING CARE INFORMATION


Reporting for a minimum of 90 consecutive days.

COST

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.

Physician’s ACO (PACO) is a Track 1+ APM in 2018


ACOs participating in the ACO Track 1+ Model must maintain participation in Track 1 of the Shared Savings Program and remain subject to the Shared Savings Program quality performance standards and reporting requirements at 42 CFR Part 425 Subpart F, which are relevant to the APM scoring standard under MIPS. As such, for purposes of the APM scoring standard, MIPS eligible clinicians in the ACO Track 1+ Model are considered to be participating in Track 1 of the Shared Savings Program.activities performance category.

CMS determined that the condition for participation under ACO Track 1+ exceeds the requirements in the improvement

  • Scoring performance based on the APM scoring standard instead of the applicable MIPS standards.
  • ACI – Report individually under MIPS
  • Quality - Use quality measure data reported through the APM.
  • CPIA – CMS will automatically assign Improvement Activity scores based on APM design (no data submission required).
  • COST – no weightage for 2018 for MIPS APM

For more information on the Quality Payment Program: QPP.CMS.GOV