Quality Scoring Logic

The CMS has updated the Quality category scoring logic for 2018. Some of the key changes to MIPS quality category scoring logic are

60 or 70% Max points

50% of final score

Select 6 of 300 and more Quality Measures as finalized for 2018 MIPS performance period
(for a full performance year to be eligible for payment adjustment);1 must be:

Outcome Measure or High Priority Measure – defined as Outcome measure, Appropriate Use measure, Patient experience, Patient safety, Efficiency measures, or Care coordination

*The all-cause readmission measure is not submitted and applies to all groups of 16 or more clinicians who meet the case minimum of 200. Beginning in 2018, MIPS eligible clinicians will be able to report for new as well as modified MIPS quality measures and specialty measure sets.

Bonus Points : Clinicians receive bonus points for eight of the following

Submitting an additional High-priority Measure

2 Bonus points for each additional Outcome and Patient experience measure

1 Bonus point for each additional High-priority Measure

Using CEHRT to submit measures to registers or CMS

1 Bonus point for end- to- end electronic data submission.

Submitting an additional High-priority Measure

2 Bonus points for each additional Outcome and Patient experience measure

1 Bonus point for each additional High-priority Measure

Using CEHRT to submit measures to registers or CMS

1 Bonus point for end- to- end electronic data submission.

Improvement percent score

For 2018, improvement in the Quality performance category will be scored and this improvement score will be included in calculating the quality performance category score. Improvement score is capped at 10% in Quality category

Topped out measures

Special scoring cap of 7 points is applied to 6 measures identified as Topped Out for the performance year 2018.

Total Quality Performance Category Score
=
Total points earned on required 6 Quality Measures
+
Measure Bonus points
Maximum number of points*
+
Improvement percent score**

Quick tip: Maximum Score cannot exceed 100
*Maximum Number of Points = # of Required Measures x 10

**Improvement scoring at Quality performance category level will be included when data is sufficient.