If a MIPS EC (eligible clinician) or group practice is interested in some incentive eligibility through MIPS quality reporting, what are the criteria for reporting?

To be eligible for any incentive, a provider or group practice would need to achieve a MIPS Composite Performance Score (CPS) higher than 15 points. One method to do this is through reporting on the MIPS quality category. A provider or group practice would report 6 individual measures and at least 1 of the 6 measures being an outcome measure. If no outcome measure is applicable then a high priority measure would need to be reported in lieu of an outcome measure. The measures would need to be reported for a full year. The provider or group practice would need to report enough to meet the data completeness threshold of 60%. If a provider or group practice reported at least 60% of all payer eligible events for a full year for 6 measures with 1 being an outcome measure, then the provider or group practice would achieve at least 18 points (6 measures x 3 points each). Activities that would increase beyond 18 points would include: selecting measures that can be scored against the benchmark deciles, reporting on the Improvement Activities (IA) category, or reporting on the Promoting Interoperability (PI) category.

Posted in: Merit-Based Incentive Program (MIPS)