decisionhealth Newsletters, Part B News - 2018 Issue 1 (January)
Discover cost measure formulas and prepare for 2018 scoring impact
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Article Overview
This article explains the two CMS cost measures that affected the 2018 MIPS performance year and how they factor into scoring. It covers attribution concepts, minimum case requirements, the role of QRUR data, and practical ways practices can review historic spending patterns to prepare for future reporting. The piece is aimed at clinicians, practice managers, and coding or revenue cycle staff who need a broad understanding of cost-based performance measurement under the Quality Payment Program.
Why This Topic Matters
Cost measures became an increasingly important part of MIPS scoring, so practices needed to understand attribution, data sources, and volume thresholds to evaluate their exposure. The article helps readers identify whether they are likely to be assessed under these measures and what information can support internal preparation.
Article Sections
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MSPB and TPCC in focus
Introduces the two CMS cost measures and summarizes the broad attribution framework used for each. It also distinguishes the general types of services and provider categories involved.
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Steps you can take to prepare
Describes how practices can use historical reporting data to review spending patterns and assess whether they are likely to meet minimum volume thresholds. It also discusses general preparation considerations for practices of different sizes.
What You Will Learn
- Which CMS cost measures were relevant to 2018 MIPS scoring
- How attribution is generally approached for the cost measures
- What kinds of historical data practices can review to prepare
- Why minimum case volume matters for cost scoring
- How practices can use reporting data to assess spending patterns
Who Should Read This
- Physicians and clinicians
- Practice managers
- Medical coders and billing staff
- Revenue cycle and quality reporting staff
- Healthcare consultants
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