Summarizing MIPS Performance Scoring & How It's Calculated

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One, Two, Three: Summarizing MIPS Scoring

MACRA/MIPS

One, Two, Three: Summarizing MIPS Scoring

AdvancedMD’s recent merit-based incentive payment system (MIPS) webinar walks the listeners through the performance scoring for each category, what’s involved and meeting the minimum or maximum adjustment.

Debra Harris, product manager, reviews MIPS performance categories and suggests ways to maximize your Composite Performance Score (CPS). She makes sure users understand the various components of CPS and what they must execute to receive their MIPS payment adjustment.

The new system seeks to increase flexibility by letting clinicians choose what measures and activities they provide and are scored on, via two pathways: MIPS, and APMs, or advanced alternative payment models. The new legislation will not be easy to navigate and 2017 is looming large. Harris provides a handy and motivational reminder: the objective is a better, smarter Medicare for healthier people with reimbursement on value over volume. That’s a goal we all can—and should—get behind!

The webinar provides a high-level overview of the MIPS performance categories and how they’re weighted:

  • Clinical Practice Improvement Activity (15%);
  • Resource Use (10%);
  • Quality, formerly PQRS (50%); and
  • Advancing Care Information, formerly the Meaningful Use (25%).

 

This topic has been explored in greater detail in previous webinars —  MIPS: CPIA & Resource Categories and MIPS: Quality & ACI Categories but check out this summary webinar for how the numbers are achieved through CMS scoring examples with detailed tables, explanations of points and calculations. Harris makes it as simple as possible, focusing on the core intent of the new methodology: It allows flexibility that enables clinicians to focus on measures that are most relevant to their practice.

In delving deeper into the MIPS Composite Performance scoring, the webinar addresses the performance category weighting, highlighting the importance of striving for more to achieve exceptional performance factors. In general, it gives users a better understanding of the CPS relationship to the CPS performance threshold. The methodology also encourages group performance, pushing the need to work together to meet common goals in health care delivery.

Harris also reminds users that the MIPS track is not a pass or fail. Your performance percentage grade is based on what you report and then by a performance threshold compared to your peers. This information will come from CMS so we know what we are striving for.

Once we’ve got our scoring, Harris moves on MIPS payment adjustments, also covered thoroughly in a previous webinar MIPS Scoring Overview. Clinicians must send their data and information for CPIA, the ACI, and Quality (Resource Use doesn’t require the submission), which is then scored and weighted.

A poll during the webinar reflected that clinicians felt somewhat confident in their ability to achieve a positive adjustment in 2019 for the 2017 performance year (Remember, it’s a two-year look-back). Here are some tips for success from Harris:

  • Stay educated on MACRA and MIPS/APMs—depending on your track.
  • Educate your practice team, look at measures in the proposed rule and pick now what you’ll file.
  • Consider benchmarking what you’re already doing and get an indication on what you need to focus on for 2017.
  • Stay informed on changes since this is a proposed rule and will change.

Preparing Your Practice for MACRA, the last installment of this series, will take place on Sept. 22. We also welcome you to get more information about the AdvancedMD user conference taking place Oct. 11-12 in Salt Lake City for great learning opportunities and peer networking.



Topic: MACRA/MIPS, Public Policy


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