The MIPS Quality Category

mips quality

The Merit-based Incentive Payment System (MIPS) is one pathway of upcoming MACRA’s Quality Payment Program. One of MIPS’ four components is the “quality” category, which ultimately comprises 50% of a provider’s MIPS score. But what is the MIPS quality category, and how does it work?

Below, we’ll take a closer look at the MIPS quality category, as well as how it may affect anesthesia providers.

What Is the MIPS Quality Category?

The MIPS quality category will replace PQRS and the VM program’s quality component. Clinicians will report six measures, as opposed to the nine measures they currently report under PQRS.

One of these reported measures must be a cross-cutting measure, and one must be an outcome measure. An anesthesia provider may be exempt from having to report a cross-cutting measure if they are found to be “non-patient facing.”

Aligning with the Private Sector

One thing this proposal aims to do is to line up more closely with the private sector by including the same core quality measures that private payers are already using for their clinicians.

Providers do have the ability to keep reporting quality measures via existing methods like claims, qualified registry, electronic health records (EHR), and qualified clinical data registry (QCDR). CMS will also calculate population measures based on claims data in addition to the data submitted by providers.

The Effect on Registry Reporting

It’s essential to note that this proposed rule will change the registry reporting requirements for 2017. Clinicians who use qualified registries will be required to report measures for all patients (not just Medicare patients).

They’ll also have to report on 90% of patients if they are reporting by way of a QCDR, and 80% if they report via claims. This is obviously a big change, so it’s vital to understand it now, before it goes into effect next year.

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