Signature Consulting Group, LLC

2017 MIPS Composite Score

Final methodology for calculating the MIPS Composite Score for individual clinicians and groups in the 2017 performance period

Quality

Between 1 and 10 points will be awarded based on performance against benchmarks for each submitted quality measure that meets the minimum case volume, up to 6 measures total.

  • 2 bonus points are awarded for additional outcome/patient experience measures, and 1 bonus point is awarded for other high priority measures.
  • 1 bonus point is available for each measure reported using Certified EHR Technology in end-to-end electronic reporting (up to 10%).
  • During the 2017 transition year, a minimum of 3 points will be awarded for each submitted measure, regardless of performance.
  • For groups of 16 or more with sufficient case volume, up to 10 additional points will be awarded for performance on the claims-based population measure, all-cause hospital readmission.

Cost

CMS will calculate Cost performance using submitted Medicare Part B claims for Per Capita Costs for all attributed beneficiaries, Medicare Spending Per Beneficiary (MSPB), and all applicable episode-based measure.

  • For the 2017 transition year, performance results will be calculated and shared with providers but will not contribute to the 2017 composite score.
  • The MSPB measure has a 35-case minimum, and all other measures have a 20-case minimum. If an individual clinician does not meet the minimum case volume, they will not receive a Cost performance category score.
  • There are no bonus points available in this performance category.

Advancing Care Information

The performance category score is capped at 100 points (out of a possible 155 points) and consists of a base score plus a performance score.

  • 50 points are available for the base score, which consists of reporting a numerator/denominator or yes/no statement for 5 measures. For numerator/ denominator measures, clinicians must report at least a 1 in the numerator; for yes/no statement measures, clinicians/groups must report a “yes” for credit.
  • 90 points are available for the performance score, which is determined based on the reported numerator and denominator for measures in 6 objectives: Patient Electronic Access, Patient-Specific Education, Secure Messaging, Health Information Exchange, Medication Reconciliation, and Public Health Reporting.
  • 5 points are available for completing Public Health and Clinical Data Registry Reporting, and 10 points are available for reporting improvement activities using Certified EHR Technology.

Improvement Activities

To receive maximum credit, individual clinicians and groups of 15 or more eligible clinicians must achieve at least 40 points through completing a combination of highand medium-weighted activities.

  • 20 points are awarded for attesting to high-weighted activities
  • 10 points are awarded for attesting to medium-weighted activities.
  • Eligible clinicians and groups participating in an APM automatically receive half credit and can increase their total by reporting additional activities.
  • Eligible clinicians and groups participating in a certified patient-centered medical home automatically earn full credit.
  • Non-patient-facing clinicians, small practices with 15 or fewer professionals, and practices located in rural areas and geographic health professional shortage areas can achieve full credit with 1 high-weighted or 2 mediumweighted activities (20 points total).