The 30 Day All Cause Hospital Readmission Measure is a measure under the Quality performance category, applicable to certain MIPS eligible practices that report as a group. If your group does not meet the definition of Small Practice (1-15 eligible clinicians), pay close attention. This measure might be required for your group and will affect your Quality category and MIPS scores.
The 30-Day All Cause Hospital Readmission Measure (ACR) is:
A risk-standardized readmission rate for beneficiaries age 65 or older who were hospitalized at a short-stay acute care hospital and experienced an unplanned readmission for any cause to an acute care hospital within 30 days of discharge.
This measure is applicable to only the groups of 16 or more clinicians. So if you are reporting as an Individual or are a group of less than 16 clinicians, this measure doesn’t apply to you. You would need to report only 6 measures for Quality Performance Category (unless your specialty set has less than 6 measures).
[Read: Decoding Submission Methods to better understand the submission requirements for 2018]
For the groups the All-Cause Readmission Measure (ACR) is applicable, the good news is that this measure doesn’t need to be reported at all. CMS will calculate it from the Administrative Claims data for your group.
Unlike the case minimum for other quality measures, the minimum case volume for the Readmission Measure (ACR) is 200. If there are less than 200 cases for your group that satisfy the denominator criteria for ACR, it will not be scored for your group. Which means that your group score will be calculated out of 60 points or 110 points (if you are submitting all the quality measures data via CMS Web Interface) for 2018 MIPS performance year.
The All-Cause Hospital Readmission Measure is an inverse measure. That means, the lower the numerator, the better score it will yield.
It is subject to the same benchmarking criteria, scoring deciles, and floor of 3 points that is applicable to other quality measures. So if your group meets the applicability and Case Minimum criteria, you will score a minimum of 3 points for this measure. However, it is important to note that CMS will only calculate and score the Readmission Measure if your group has submitted data for the other two performance categories – Promoting Interoperability (PI) and Improvement Activities (IA). This is to prevent the groups not reporting other measures be scored under the Quality category just for this measure and get credit for it. Seems fair.
Determine the best measures to submit and the best way to submit them with MyMipsScore. Get help for the 2018 submissions and get started for the 2019 MIPS performance year.