Measure Selection: Which MIPS measures should your organization report?
- Analyze provider/practice utilization to understand the patient population (i.e., conditions treated, services rendered, etc.).
- Evaluate existing technology to determine data capture and reporting readiness for relevant measures.
- Interview key personnel to further understand the aspects of MIPS most meaningful to the provider/practice (i.e., as may align to measures within each of quality, CPIA, ACI, cost and resource use).
- Determine ACI exemption eligibility (e.g., ≥75% hospital-based services, ≤100 “patient-facing” encounters).
- Recommend specific MIPS measures for participation.
Readiness Assessment: What do you need to do to prepare for MIPS?
- Evaluate level of staff and clinician MIPS awareness.
- Evaluate existing PQRS and MU processes for capture and reporting.
- Review 2015 QRUR to understand existing cost and quality measure performance.
- Determine EHR-reporting eligibility (i.e., 2014 or 2015 edition).
- Identify high-performing areas and areas to be strengthened.
- Recommend reporting submission method (e.g., claims, qualified registries, certified EHR technology).
Score Calculation: How will you score MIPS?
- Generate a sample report of the required data for all chosen MIPS measures for a minimum 90 day period and generated by the selected reporting submission method.
- Evaluate the complete and accurate reporting of each measure.
- Calculate Quality score for the sample measure set up to 80-90 points (depending on group size) towards 60% of the overall MIPS score (or 85% if ACI-exempt).
- Calculate ACI score for the sample measure set up to 100 points towards 25% of the overall MIPS score (or 0% if ACI-exempt).
- Calculate CPIA score for the sample measure set up to 40 points towards 15% of the overall MIPS score.
- Calculate overall sample MIPS score to ensure neutral participation at a minimum, or at the required level to meet higher-performing provider/practice goals.