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“Macharris what is the scoring methodology for the merit based incentive payment system. I m m molly macharris with ccsq and i will be leading you through this discussion. So exactly will we be scoring clinicians under the mips program. I will talk us through this or i will take us through this through the performance categories.
So let s start first with how we will score clinicians under the quality performance category. So again the performance requirements are that clinicians would need to choose six measures out of a set of close to 300 clinicians will receive points per measure clinicians can receive between a range of three to 10 points per measure for measures where a clinician could have reported or performed on a measure and they do not clinicians would get a zero for that particular measure. We also do have bonus points. Available under the quality performance category to incentivize certain types of measures and measurement activities the bonus points.
Include measures that are outcome based and measures that are deal with patient experience and we also have bonus points for clinicians who participate in end to end reporting using their certified ehr technology. So how exactly do we calculate the quality performance category. So we take the points that are earned under the six quality measures again for each measure. It would range from three to 10 points or zero points.
If nothing is received we would then add any bonus points and then divide that by the maximum number of points. Available. And that would result in the quality performance category score. So how would we calculate the cost performance category.
So as i mentioned in previous training modules. We are not measuring cost for the first year under the mips program. But how we would calculate cost is that clinicians could receive up to 10 points per cost measure and the way that the cost performance category would be calculated. So very similar to quality as we would take all of the points.
That are received and then divide that by 10 times the number of scored measures. But again remember we are not calculating cost for the first year. So this is more just information on how we would calculate the cost performance category for a future year. So.
How are we calculating the improvement activities performance category. Under the improvement activities performance category. There are certain activities that clinicians can choose from a set of over 90 each of those activities has a corresponding weight those weights are either medium or high and medium weights count for 10 points high activities count for 20 points. The majority of clinicians want to get to 40 points.
So clinicians can get to those 40 points by doing any combination of medium or high activities and then for those clinicians under the improvement activities performance category. That receive special scoring so clinicians such as non patient. Facing clinicians clinicians that are in rural or hpsa areas that are a part of small practices. They would their activities would be double weighted so what that means is that for those clinicians their medium activities would count for 20 points.
And their high activities would count for 40 points. So again a similar mathematical equation to what we have under the other performance categories. We take the total number of points that were received divide that by the maximum number of points times. That by 100 and that results in the improvement activities performance category score.
And let s go to the next slide for advancing care information. So the advancing care information. This one is calculated a little bit differently there are there is a base score. Which counts for 50 percent.
There is a performance score. Which there s 90 percent available and then a bonus score. Which is 15 percent that results in a 155 percent maximum score. Which would then be capped at 100 and then scaled to the 25 performance points.
Available. And you may be asking why 155 percent. This structure was deliberately created to ensure that clinicians have absolute flexibility to focus on the measures that are most relevant to them and their practices. Goal under the advancing care information performance category was to shift the concentration away from measures that were not applicable.
So then to roll up the advancing care information performance category score. Again it s that base score. Which is 50 points the performance score. Which is 90 points and then the bonus score.
Which is 15 points. Which results in 155 points. Which would then get scaled down to 100 to a total potential of 25 points. So how do we actually calculate a final score for mips eligible clinicians.
We take the performance category scores. That are earned under each of those performance categories add those up multiply that by 100 and that would result in a numerical score for each mips eligible clinician. So with these numerical scores. There re a couple of numbers that are really important for everyone to be aware of so starting at the bottom of this table.
The number zero. So clinicians whose final score is the number zero. They would be receiving a negative 4 percent payment adjustment in 2019. This would be for clinicians who are eligible to participate.
But they do not do anything the next number. That s important is the number three that is the mips performance threshold. And that is the number that clinicians would need to hit to avoid a negative payment adjustment and if they hit that number three they would receive a neutral payment adjustment. So no impact to their claims in 2019 for clinicians final scores that are above the number three and go up to 69 points.
They would be receiving a positive mips adjustment. And then the last number that s important is the number 70 and for clinicians whose final score is at or above the number 70. Not only would they be receiving a positive mips adjustment for their participation. They would also be receiving an additional positive adjustment for exceptional performance.
This discusses the additional adjustment factors for exceptional performance. So we do have the ability for the first few years under the mips program for clinicians to receive an additional payment adjustment for exceptional performance again this only applies for clinicians whose final score is above the number 70. Where can i go to learn more we have a lot of additional information for all clinicians stakeholders. Everyone involved who wants to learn more about the quality payment program at the quality payment program.
Portal website which is at qppcmsgov. We also have organizations on the ground that are available to provide clinicians additional information on how the quality payment program works. A few that i want to call out include the transforming clinical. Practice.
Initiative or. Tcpi. Tcpi is designed to support more than. 140000.
Clinician practices over the next. Four years in sharing. Adapting and further. Developing their comprehensive quality improvement strategies.
Clinicians. Participating in tcpi will have the advantage of learning about mips and how to move toward participating in advanced apms. We also have quality innovation network and quality improvement organizations so qin qios the qio programs 14 qin qios bring medicare beneficiaries providers and communities together in data driven initiatives that increase patient safety make communities healthier better coordinate post hospital care and improve. Clinical quality.
And if you are in an apm. The innovations center s learning systems can help you find specialized information about what you need to do to be successful in the advanced apms thank you for viewing this presentation for more information please visit the quality payment program website at qppcmsgov. ” ..
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In this lesson, Molly MacHarris, MIPS Program Lead with the Center for Clinical Standards and Quality, examines the scoring methodology for the Merit-based Incentive Payment System (MIPS). You will learn about how points are awarded within each MIPS performance category (Quality, Cost, Improvement Activities, and Advancing Care Information) as well as how the Final Score is calculated. You will gain an understanding of how payment adjustments are made, and what it means for an eligible clinician to be considered an exceptional performer. Finally, you will learn about the available Technical Assistance to help eligible clinicians succeed under the Quality Payment Program. Visit qpp.cms.gov for additional resources and questions.
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Medicare, Medicaid, CMS, Healthcare, Health Care, Beneficiaries, Providers, eHealth, Quality Payment Program, Merit-based Incentive Payment System, Final Sco…