CMS looks for feedback on new MIPS cost measures

The Centers for Medicare & Medicaid Services (CMS) is field-testing several new cost measures that could later be added to the cost category of the Merit-based Incentive Payment System (MIPS). And CMS is looking for your help.

If finalized, the measures would be included in MIPS beginning with the 2020 performance year. Physicians can access field reports on their performance on the proposed measures through the CMS Enterprise Portal and are encouraged to provide feedback on the measures through an online survey by Oct. 31.

There are 11 new episode-based cost measures included in the field reports:

• Acute kidney injury requiring new inpatient dialysis
• Femoral or inguinal hernia repair
• Elective primary hip arthroplasty
• Hemodialysis access creation
• Inpatient chronic obstructive pulmonary disease exacerbation
• Lower gastrointestinal hemorrhage
• Lumbar spine fusion for degenerative disease, 1-3 levels
• Lumpectomy, partial mastectomy, simple mastectomy
• Non-emergent coronary artery bypass graft
• Psychoses/related conditions
• Renal or ureteral stone surgical treatment

CMS is also re-evaluating two cost measures:

• Total per capita cost
• Medicare spending per beneficiary (MSPB)

It is important to note that these last two items are not the same measures currently being used in MIPS. Feedback on these measures is for informational purposes and will not affect future MIPS scoring.

CMS will generate field reports for physicians if they meet the following minimum case thresholds:

• 10 episodes for at least one of the episode-based measures,
• 35 episodes for the MSPB measure, or
• 20 beneficiaries for the total per capita cost measure.

Additional information, including draft measure specifications and mock reports, are available on the CMS MACRA Feedback page. CMS has also created a User Access Guide to assist physicians in accessing their reports.

– Erin Solis, Regulatory Compliance Strategist for the American Academy of Family Physicians