CMS Releases 2017 Quality Measure Benchmarks for MIPS
Late this afternoon, CMS released the 2017 Quality Measure Benchmarks for MIPS. Each measure is assessed against its benchmarks to determine how many points the measure earns. Benchmarks are specific to the type of submission mechanism: EHRs, QCDRs/Registries, CAHPS and claims.
Each benchmark is presented in terms of deciles. Points will be awarded within each decile (see table below). Clinicians who receive a score in the first or second decile will receive 3 points. Clinicians who are in the 3rd decile will receive somewhere between 3 and 3.9 points depending on their exact position in the decile, and clinicians in higher deciles will receive a corresponding number of points. For example, if a clinician submits data showing 83% on the measure, and the 5th decile begins at 72% and the 6th decile begins at 85%, then the clinician will receive between 5 and 5.9 points because 83% is in the 5th decile. For inverse measures, such as an unplanned vitrectomy, where a positive performance is seen in a lower score, the scores are reversed in the benchmark deciles, and higher scores are in lower deciles but the lowest deciles still receive the lowest points.
For measures with no historic benchmark, MIPS will attempt to calculate benchmarks based on 2017 performance data. Benchmarks are created if there are at least 20 reporting clinicians or groups that meet the criteria for contributing to the benchmark, including meeting the minimum case size (which is generally 20 patients), meeting the data completeness criteria, and having performance greater than 0 percent (less than 100 percent for inverse measures). If no historic benchmark exists and no benchmark can be calculated, then the measure will receive 3 points.
We will provide additional details in next Friday’s Washington Watch Weekly. If you have questions, please contact Allison Madson, manager of regulatory affairs, at email@example.com or 703-591-2220.