Healthmonix recommends a quarterly review of performance for each reporting category and a final review by Jan. 15. This performance review should ensure you're on track to meet your organization's reporting goals and provide you time to document and refine any improvement areas.
A review of your performance can only happen after you've completed all of your onboarding steps and uploaded data for the Quality and Promoting Interoperability categories. Standard performance category score weights are:
- Quality — 30
- PI — 25
- IA — 15
- Cost — 30
MIPS participants with standard weighting can earn 70 points of their MIPS final score by reporting the Quality, PI, and Improvement Activities categories. The Cost category and complex patient bonus are calculated by CMS after you submit your MIPS report. So, there is a potential of up to 40 points (30 for the Cost category and 10 for complex patient bonus) that aren't included in your MIPSpro score.
Even with perfect scores in the Quality, PI, and IA categories, you'll only be at 70 points and submitting below the 75-point threshold. You won't know your final score until performance feedback reports are released in the summer.
Performance checklist
- Review your MIPS score.
- If your score is 0, make sure you've completed all onboarding steps, finished your profile, and selected measures for all performance categories.
- Review the Quality category score.
- If your score is 0 and you've submitted data, check the Completion Threshold page and complete it. If you can't complete the Completion Threshold page, review your predicted score instead of your actual score.
- Review/toggle the Actual Score on the Quality Points page.
- Take note of your top 6 measures.
- Take note of measures that receive bonus points.
- Take note of measures without benchmarks.
- Take note of measures that are topped out or capped at 7 points.
- Make a plan to improve your Quality score (if needed).
- Select additional measures to replace measures without benchmarks or topped-out measures.
- Review the PI category score.
- If your score is 0 and you've submitted data for this category, review the selected measures and make sure your data is complete for each measure. Additionally, you'll need 1 met instance for each measure to receive a category score.
- Check for exclusions. If your score is 0, you may be able to claim an exclusion for a category if you restrict the reporting range to 180 days.
- Consider reporting an exclusion for low-performing measures with fewer than 100 eligible cases.
- Consider reporting your best 180 days for the 2024 performance year instead of a full performance year.
- Review the IA category score.
- If your score is 0, make sure you have attested to the improvement activities you plan on reporting.
- If your score is 7.5, consider reporting additional improvement activities to receive full credit.
- Cost. CMS determines this score. It ranges from 0-30.
- Complex patient bonus. CMS determines this score. It ranges from 0-10.
This article was updated Nov. 18, 2024.