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MIPS - Scoring
The MIPS scoring will be a composite score of the 4 performance categories:
- Quality – worth 50% of the total. Must report on 6 measures worth up to 10 points each and scored against benchmarks. Bonus points for reporting an additional outcome or high-priority measure and for end-to-end reporting.
- ACI – worth 25% of the total. Base score is worth 50 points, and performance plus bonus score potential points are 155, but with a maximum score of 100 (base+performance+bonus)
- Improvement Activities – worth 15% of the total MIPS score. Clinicians or groups must earn a total of 40 points. High weighted activities are worth 20 points and medium weighted activities are worth 10 points. Small, rural, or HPSA clinicians or groups earn double points.
- Cost – worth 10% of the total score. Maximum score is 10 points for either TCC or MSPB, or the average of the 2 measures calculated by CMS.
Clinicians or groups must earn at least 15 points across all categories in order to avoid penalties and remain neutral.
|2018 Final Score||2018 Payment Adjustment|
|≥ 70 points||
Thus below is how to a minimum of 15 performance points to achieve a neutral adjustment:
|Quality||Improvement Activities||Advancing Care Info|
|Submit 6 measures that meet data completeness||Report 2 high-weighted or 4 medium-weighted activities for 90 days||Meet Base Score plus 1 quality measure (OR 1 performance measure)|
|Report 1 medium weighted activity PLUS ACI Base Score||Report 1 medium weighted activity PLUS ACI Base Score|
|Small practices: Report enough quality measures to achieve 10 points (in addition to the 5 automatic points). Example: score well on 2 complete measures and submit 4 other incomplete measures.||Small practices: 1 high-weighted or 2 medium-weighted activities for 90 days||Small practices: Base score plus enough quality measures to achieve 5 points.|
For the 2018 performance period, there are new ways to earn bonus points:
- Complex patient bonus – 1-5 bonus points toward the composite score calculated as an average HCC risk score
- Small practice bonus – Practices with ≤ 15 clinicians automatically earn 5 bonus points so must earn at least 10 points in 1 performance category