2018 What is the Quality performance category in MIPS?

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.

More information

  • Access the CMS Fact Sheet for 2018 Quality performance category here.
  • Access the CMS Fact Sheet for 2018 Quality Payment Program reporting Year 2 here.
  • CMS also provides further resources for 2018 Quality Payment Program here.

Quality Payment Program

  1. 2018 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  2. What is the MIPS Dashboard watch list and how do I use it?
  3. How does the MIPS Dashboard work?
  4. What is the Promoting Interoperability (formerly Advancing Care Information) performance category in MIPS?
  5. 2018 What is the Quality performance category in MIPS?
  6. 2018 What are Improvement Activities in MIPS?
  7. Which Improvement Activities qualify for the Promoting Interoperability performance category bonus in 2018?
  8. What is the Cost performance category of MIPS and how is it scored in 2018?
  9. How is the MIPS Final Score Calculated in 2018?
  10. What is a MIPS eligible clinician in 2018?
  11. MIPS for Small, Rural and Underserved Practices
  12. 2018 PI Transition Measure: Medication Reconciliation
  13. 2018 PI Transition Measure: Electronic Prescribing (eRx)
  14. 2018 PI Transition Measure: Secure Messaging
  15. 2018 PI Transition Measure: Security Risk Analysis
  16. 2018 PI Transition Measure: Health Information Exchange
  17. 2018 PI Transition Measure: Immunization Registry Reporting
  18. 2018 PI Transition Measure: Specialized Registry Reporting
  19. 2018 PI Transition Measure: Syndromic Surveillance Reporting
  20. 2018 PI Transitional Measure: View, Download, or Transmit (VDT)
  21. 2018 PI Transition Measure: Provide Patient Access
  22. 2018 PI Transition Measure: Patient-Specific Education
  23. What is the Practice Fusion QCDR?
  24. 2017 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  25. How do I report my 2017 MIPS data to CMS using the Practice Fusion QCDR?
  26. What is the Advancing Care Information (ACI) Performance Category for MIPS and how is it scored?
  27. 2017 ACI Transition Measure: Security Risk Analysis
  28. 2017 ACI Transition Measure: Electronic Prescribing (eRx)
  29. 2017 ACI Transition Measure: Provide Patient Access
  30. 2017 ACI Transition Measure: Health Information Exchange
  31. 2017 ACI Transition Measure: View, Download, or Transmit (VDT)
  32. 2017 ACI Transition Measure: Patient-Specific Education
  33. 2017 ACI Transition Measure: Secure Messaging
  34. 2017 ACI Transition Measure: Medication Reconciliation
  35. 2017 ACI Transition Measure: Immunization Registry Reporting
  36. 2017 ACI Bonus Measure: Syndromic Surveillance Reporting
  37. 2017 ACI Bonus Measure: Specialized Registry Reporting
  38. What is the Improvement Activities Performance Category for MIPS?
  39. What are the Quality performance category reporting requirements for MIPS?
  40. What is the difference between the two Advancing Care Information measure sets available in 2017?
  41. What are Alternative Payment Models (APMs) and Advanced APMs?
  42. What is Comprehensive Primary Care Plus (CPC+)?
  43. Which Improvement Activities Qualify for the Advancing Care Information (ACI) Bonus Score in 2017?
  44. How do I contact CMS about the Quality Payment Program?
  45. How do I indicate interest in the Practice Fusion QCDR and get my MIPS estimated scores?
  46. Chronic Care Management FAQs
  47. How do I export a JSON file for 2017 MIPS reporting?
  48. How is the MIPS Final Score Calculated in 2017?

Feedback and Knowledge Base