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Update: Submitting fewer than six quality measures?

MIPS Eligible Measure Applicability (EMA): New Resources

MIPS Quality Performance Category: Eligible Measure Applicability  

Quality is one of four performance categories under the Merit-based Incentive Payment System (MIPS). For 2017, to fully participate in the Quality performance category, you need to report on:

  • Six quality measures, one of which is required to be an outcome measure, if available. If an outcome measure is not available, then you have to submit a high priority measure. You or your group would also have to meet the data completeness requirement (at least 50% of possible data submitted) for each measure submitted. (For more on outcome measures, high priority measures, and data completeness requirements, see the Quality Performance Category Fact Sheet.)

—OR—

  • A complete specialty measure set. All of the measures in a specialty set (measures specifically for specialties such as Anesthesiology, Cardiology, and Ophthalmology) will be assessed when less than 50% of possible data are submitted.

If you submit data on fewer than six quality measures, CMS will conduct an eligible measure applicability (EMA) process to identify clinically related measures you could have submitted. The EMA analysis applies only if you submit data through claims or a qualified registry, and if you submit less than the required quality measures for a program year.

The EMA process:

  • Uses a clinical relations test to see if you could have submitted more measures, including outcome and high priority measures
  • Adjusts the scoring to accurately reflect how the clinical relations test affected your or your group’s performance

Find Out More

To learn more about the EMA analysis and how it affects your quality performance calculation and score, see:

 

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