Under the Medicare Quality Payment Program track known as MIPS (Merit-based Incentive Payment System), your payments in 2020 will be affected by your performance on the six quality measures you choose to report in 2018. It is logical to think you should report on those where your performance is best, but be sure to consider these four factors as well:
Benchmarks and decile scoring. Because your score is determined relative to a benchmark, you might receive more points for a lower screening rate if it falls into a higher decile relative to other physicians.
“Topped out” measures. Avoid reporting on measures with benchmarks so high that you will need a very high performance rate to score in the top decile and maximize your points. The Centers for Medicare & Medicaid Services (CMS) labels these as “topped out” measures.
Scoring requirements. CMS requires that performance data meet three criteria for reliable scoring. They must be comparable to a national benchmark and meet data completeness standards and case minimums.
Bonus points. If you report on certain high-priority measures or use end-to-end electronic reporting techniques, you can receive bonus points. In fact, you can potentially increase your quality score by up to 20 percent, which would help offset lower performance scores.
View the eligible quality measures on the CMS website.
Sign up to receive FPM's free, weekly e-newsletter, "Quick Tips & Insights," featuring practical, peer-reviewed advice for improving practice, enhancing the patient experience, and developing a rewarding career.