Quality Still the MIPS Heavyweight in 2019

Why This Topic Matters

Quality remains a major driver of MIPS scoring, so understanding the year’s category structure and reporting considerations can affect Medicare payment adjustment outcomes and reporting strategy.

Article Sections

1. The Basics

   Introduces the 2019 Quality category within MIPS and summarizes its role, reporting scope, and timing. Also notes changes affecting small practices and overall scoring.

2. Specialty Measures

   Describes CMS specialty sets and highlights the availability of a nephrology-focused measure set. Explains that specialty-aligned measures may be useful for reporting strategy.

3. Submission Methods

   Covers the general approach to submitting Quality data to CMS for 2019 and notes that multiple submission types may be combined. Discusses the reporting landscape at a broad level.

4. Benchmarks are Important

   Explains why measure benchmarks matter and how benchmark values can differ by submission method. Uses a Quality measure example to illustrate the importance of reviewing benchmarks before selecting measures.

5. Topped-Out Measures

   Reviews the concept of topped-out measures and why they require careful consideration during measure selection. Also notes broader measure lifecycle changes discussed in the final rule.

6. 20 Case Minimums and Data Completeness

   Summarizes the relationship between case minimums, data completeness, and earning maximum Quality points. Emphasizes the need to confirm eligibility and reporting volume.

7. Year-Over-Year Improvement

   Describes the existence of improvement-based Quality points for providers reporting in consecutive years. Refers to comparison of performance between 2018 and 2019 at a general level.

8. Next Steps

   Offers a high-level planning checklist for approaching Quality reporting during the year. Focuses on strategy, timing, and measure review.