Quality Still the MIPS Heavyweight in 2019

Why This Topic Matters

The Quality category remains a major driver of MIPS performance, so understanding the 2019 framework helps practices choose measures strategically, prepare submissions appropriately, and anticipate how reporting choices affect scoring.

Article Sections

1. The basics

   Introduces the 2019 Quality category within MIPS and outlines the general reporting structure, scoring weight, and performance period. Also notes practice-size related scoring changes and general background resources.

2. Specialty measures

   Discusses specialty measure sets published by CMS and highlights the existence of a nephrology-focused set. Covers the general idea of using specialty-specific measures when selecting reporting options.

3. Submission methods

   Reviews the available Quality data submission approaches for 2019 and notes changes in submission terminology. Also addresses how reporting types can be combined for credit.

4. Benchmarks are important

   Explains the role of measure benchmarks in Quality scoring and describes how benchmark values may vary by submission method. Uses an example measure to illustrate why benchmarks matter when selecting measures.

5. Topped-out measures

   Covers the concept of topped-out measures and the implications for Quality scoring. Also discusses broader policy direction around measure retirement and the types of measures CMS is emphasizing.

6. 20 case minimums and data completeness

   Addresses the relationship among case minimums, data completeness, and Quality scoring. Summarizes the general scoring conditions that affect whether a measure can earn maximum credit.

7. Year-over-year improvement

   Describes the availability of improvement points in 2019 for participants reporting in consecutive years. Explains the topic at a high level and points to comparison of prior and current performance.

8. Next steps

   Provides a practical checklist for approaching Quality reporting at a high level. Focuses on planning, measure selection, submission strategy, and monitoring progress through the year.