BC Advantage - 2017 Issue 1
Quality Benchmarks: How to Estimate Your MIPS Quality Score
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Article Overview
This article explains the CMS benchmark approach used to score the MIPS quality category for the 2017 performance year. It covers how benchmarks are derived, how deciles and point values relate to reported performance, what happens when a measure is new or lacks a benchmark, and the general steps clinicians can use to estimate an overall quality score. It is aimed at clinicians, coding and quality staff, and anyone trying to understand MIPS quality reporting and measure selection.
Why This Topic Matters
Understanding benchmark-based scoring helps reporting teams estimate quality performance, compare measure options, and plan for MIPS submission strategies during a transition period.
Article Sections
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Benchmarking and decile-based quality scoring
Introduces the CMS benchmark approach for the MIPS quality category and explains the general relationship between national performance benchmarks, deciles, and point assignment.
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New measures and benchmark limitations
Discusses how CMS handles newer measures, what general conditions affect whether a benchmark can be established, and the implications for scoring when a benchmark is not available.
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Estimating your quality score
Outlines the broad steps involved in estimating a quality score using measure performance, the CMS benchmark spreadsheet, submission type, and bonus points.
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Transition-year considerations
Summarizes the article's discussion of the transition-year environment and the general advice to use the period to evaluate measure and submission choices.
What You Will Learn
- How CMS benchmark-based scoring is structured for the MIPS quality category
- How deciles relate to reported measure performance at a high level
- What general issues can arise when reporting newer measures
- How clinicians can estimate an overall quality score using CMS benchmark information
- Why transition-year conditions affect measure selection and planning
Who Should Read This
- Clinicians reporting under MIPS
- Quality reporting staff
- Practice administrators
- Coding and reimbursement professionals
- Healthcare consultants
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