2017 MIPS Requirements

Final requirements for full participation in MIPS during the 2017 performance period

Quality

Eligible clinicians and groups must report 6 measures, including 1 outcome measure or, if an outcome measure is not available, 1 other high-priority measure (appropriate use, patient safety, efficiency, care coordination or patient experience).

  • If the clinician cannot or does not report one or more of the required measures, he/she will be scored on the measures that are submitted.
  • Clinicians can select from the CMS-approved list of all MIPS measures or can select a single set of specialty-specific measures. If the set includes more than 6 measures, clinicians can select any 6 that meet the above requirements.
  • Measures reported via QCDR and Qualified Registry must include at least 50% of an eligible clinician or group’s entire patient population, regardless of payer, and a minimum case volume is required for each measure.
  • Groups of 16 or more who meet a minimum case volume will also be evaluated on 1 population measure, all-cause hospital readmissions (ACR), calculated from submitted Medicare Part B claims.

Cost

CMS will calculate Cost measures based on submitted Medicare Part B claims data, so there are no additional reporting requirements for clinicians and groups under this performance category.

  • Clinicians and groups will be assessed on all measures applicable to them.
  • Common measures applied to all individuals and groups include Medicare Spending per Beneficiary (MSPB) and Total Per Capita Costs for all attributed beneficiaries.
  • For 2017, CMS has finalized 10 episode-based measures which will be applied based on applicability.
  • Cost measures, which have case minimums of either 20 or 35, will be attributed to individual clinicians at the TIN/NPI level. For groups that participate in group reporting in other MIPS performance categories, Cost performance category scores will be determined by aggregating the scores of the individual clinicians within the TIN.

Advancing Care Information

The Advancing Care Information score replaces Meaningful Use and focuses on the secure exchange of health information and the use of certified EHR technology

  • The first component is called the “base score,” for which eligible clinicians must report either “yes” (for yes/no measures) or a numerator of at least 1 (for numerator/denominator measures) for 5 measures included in the following objectives: Protect Patient Health Information, Electronic Prescribing, Patient Electronic Access, and Health Information Exchange.
  • The second component is the “performance score,” based on performance rates for selected measures in the following objectives: Patient Electronic Access, Patient-Specific Education, Secure Messaging, Health Information Exchange, Medication Reconciliation, and Public Health reporting.
  • Clinicians/groups can also earn bonus points for reporting “yes” on measures associated with the Public and Clinical Data Registry Reporting objective or by reporting improvement activities using Certified EHR Technology.

Improvement Activities

The Improvement Activities performance category rewards eligible clinicians and groups for participating in and completing patient-centered activities that have a proven association with improved health outcomes.

  • CMS has finalized over 90 activities designated as either high- or mediumweight. Clinicians must attest to completing a combination of these activities.
  • Eligible clinicians/groups participating in certain patient-centered medical homes will receive full credit for this category, and Alternative Payment Model (APM) participants will receive at least 50% credit.
  • Practices with 15 or fewer clinicians and practices located in rural areas and geographic health professional shortage areas need to attest to completing fewer activities in order to receive full credit.
  • An improvement activity must be performed for at least 90 consecutive days during the performance period to earn credit in this performance category.