MIPS - 3 Considerations to Maximize Quality Score

It’s almost spring time. The time of transition. Out with the old (PQRS), and in with the new (MIPS). As providers gets ready to submit their last PQRS report this month, it is the perfect time to understand how MIPS is different from its predecessors. The process of selecting the quality measures for PQRS and Meaningful Use has mostly been guided by quality measures that your EHR vendor supported. With MIPS, you need to adopt Scrabble like approach. Here are 3 reasons why:

1. The Measures Matter

Not all measures are created equal. The quality category scoring under MIPS follows a new decile based benchmarking system. Under this new system, each quality measure is assigned a benchmark. The exact same performance for two measures that both meet the Case Minimum and Data Sufficiency criteria, could yield widely different scores for the same submission method.

For instance, 90% performance for EHR submission method will earn 10 points for Measure #236 – Controlling High Blood Pressure, but just 4.4 points for Measure #130 – Documentation of Current Medications in the Medical Record.

2. Submission Method Matters Even More

The same measure can have a different score depending upon the Submission Method chosen as each Submission Method has a separate benchmark for an applicable measure based on the historical data.  

For Measure #130 – Documentation of Current Medications in the Medical Record, given 95% performance, you earn 3 points if you use Claims, but almost double the points if you use Registry or EHR.

3. Only ONE Submission Method Allowed Per Category  

This restriction further complicates the selection process. After you shortlist the measures that are most applicable to your practice, and you have data available for them, you might discover that a couple of measures work better with Registry submission method and another few earn you a higher score with EHR Submission method. That's a very tricky position to be in. 

Therefore, it is imperative that you enter data for as many measures you can, and compute the scores for all available measures for all submission methods before you zero in on the 6 measures that you will submit. In the example below, EHR jumps out as the best option.  

How Can MyMipsScore Help?

We have flipped the traditional method of Submission Method selection on its head to help providers maximize their MIPS score and thus their Positive Payment Adjustment. Instead of pre-determining your submission method based on the options built in your EHR, MyMipsScore helps you select the best combination of the measures and the submission method to get you the highest score.


Learn how you can start analyzing and maximizing your MIPS score.


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