What is the Quality performance category?
Quality is one of the four performance categories that will be considered and weighted for scoring an eligible clinician’s performance under the Merit-based Incentive Payment System (MIPS) in 2018. Quality measures are tools that help us measure health care processes, outcomes, and patient experiences of their care. There are more than 270 quality measures that are final for reporting for the 2018 performance period in the Quality Payment Program. Practice Fusion currently supports 23 quality measures that can be reported for MIPS in 2018 directly in the EHR.
What is new in the Quality performance category in 2018 compared to 2017?
- The weight for this performance category has been lowered and now counts towards 50% of the total MIPS score.
- CMS has raised the minimum number of days to report from 90 days to a full calendar year.
What do I have to do for the Quality performance category in Year 2 (2018)?
Starting in 2018, the required performance period for the Quality performance category is a full 12-month calendar year. When you report a full year of quality data, CMS gets a more complete picture of your performance and you have a greater chance to earn a higher positive payment adjustment. You will also have the chance to raise your 2018 Quality category score based on your rate of improvement from your Quality category score in the transition year.
In order to earn full points for the Quality performance Category for most data submission mechanisms, a clinician or group has to report the following:
- Six quality measures (or a complete specialty measure set) for the 12-month performance period.
- The six measures must include at least 1 outcome measure or another high priority measure in the absence of an applicable outcome measure.
Practice Fusion has been selected as a CMS-certified Qualified Clinical Data Registry (QCDR) for the 2018 performance year, which means you can report the eCQMs in Practice Fusion directly to CMS without using another service or having to log into the CMS website. More information about reporting for MIPS using the Practice Fusion QCDR will be available in Fall 2018.
What if the Practice Fusion EHR does not have 6 quality measures relevant to my practice?
If you cannot find 6 quality measures you wish to report on from those supported by Practice Fusion, you may explore other quality measure reporting mechanisms or report as many measures as you can from Practice Fusion. Under MIPS, you can receive credit for reporting any measure, up to 6, that has data in the denominator and numerator. You may also explore other quality measure reporting mechanisms that may be better for your practice, such as claims-based reporting or reporting through a Qualified Registry.
How is the Quality performance category scored in 2018?
The weight of the Quality performance category is 50% of your MIPS final score. Quality measures that can be scored against a benchmark will receive between 3 and 10 points as measure achievement points. Quality measures that don’t have a benchmark or do not meet the case minimum (e.g., a denominator of 20) will receive 3 points. To determine a specific quality measure benchmark in Practice Fusion, “watch” the measure in the MIPS Dashboard and applicable benchmarks can be seen on the performance bar as shown below.
Each submission mechanism requires a minimum amount of data to meet data completeness requirement: QCDR, qualified registry, and EHR submission mechanisms require at least 60% of all-payer patients or visits qualifying for the denominator of each measure to be reported. Quality measures that don’t meet data completeness requirements (60% for 2018) will receive 1 point instead of 3 points. There is one exception in which small practices, consisting of 15 or fewer eligible clinicians, would receive 3 points.
There are multiple opportunities for eligible clinicians to earn bonus points in the Quality performance category in 2018:
- If you participated in MIPS in 2017, you can also earn up to 10 bonus points based on improvement at the Quality performance category level from 1 year to the next.
- Practice Fusion EHR users who report data to CMS using the Practice Fusion QCDR will receive 1 bonus point per quality measure, up to six measures, for meeting the end-to-end electronic reporting requirements.
- There are also bonus points available for submitting additional measures beyond the minimum six required for the complete scoring, including 1 bonus point for each additional high priority measure, and 2 bonus points for each additional outcome and patient experience measure. Note that this bonus only applies for outcome and high priority measures submitted in addition to the minimum one outcome/high priority measure that is required.
Practice Fusion makes reporting for MIPS easy
Practice Fusion’s MIPS Dashboard is an easy-to-manage tool that allows you to track your progress for MIPS. You can use the MIPS Dashboard and its intuitive watch list functionality to monitor your performance on the MIPS measures and activities you may want to report, with no limit to the number of items you can track throughout the year.
Practice Fusion has again been recognized by CMS as a Qualified Clinical Data Registry (QCDR) for the 2018 performance year, which means Practice Fusion EHR customers can efficiently track and report MIPS data to CMS directly through the EHR. More information about participating in the Practice Fusion QCDR will be available in Fall 2018.