This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.
It’s time to start diving into more of the details of the MIPS performance categories. For reference, be sure to check out our previous post on the MIPS Performance Category Weightings to see how the Quality performance category fits in with the other MIPS performance categories. The Quality performance category makes up 60% of your MIPS composite score. So, this is a very important category. If you’re looking for a formal course that dives into the nitty gritty details of this category, check out this course taught by Wayne Singer that covers the MIPS Quality Performance Category ($150 off the course if you use this link) in detail.
The Quality performance category is a replacement of the program we now know as PQRS. The program is simplified a little and they have created specialty specific measure sets. This is a valuable resource since the number of measures available in the quality performance category is quite large.
In the Quality performance category you must select 6 measures and at least one measure must be an outcome or high-priority measure. Scoring of these measures will go as follows:
Here’s how you calculate your quality performance category score:
If you’ve been participating in PQRS, this MIPS performance category won’t be a big issue for you. You’ll likely achieve a high score and be well on the road to doing very well with MIPS. If you haven’t been doing PQRS, then you have some work to do. The nice thing is that there are a lot of organizations with experience with PQRS and you can learn from them. Plus, your EHR vendor should be very familiar with PQRS as well and should be able to help.
That’s all for this week’s MACRA Monday. Next week we’ll talk about the Cost Category and new Clinical Practice Improvement Activities (CPIA) Category.
Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.
This is the same “self-reporting” BS that is PQRS.
You have to “extract” the data from your EHR, many times having to pay extra for this, or from a third party to do it. Get it into the format the registry wants, again, a charge.
Upload the data. The registry then churns through it and then gives any errors back to you.
then you have to pay someone to ENTER the data that the performance was met. AND then upload it back to the Registry, and hope that it is not in error some way or you get penalized, don’t forget the Registry charges a ton to upload the info to Medicare.
We are talking THOUSANDS of data points. Ridiculous. So tell me how does this “show” quality, when I report 6 and someone else reports a different 6 and the millions of combinations of that. Plus its all self-reported and NOTHING to do with outcomes. Only that you clicked a box. Congrats CMS, that is your BS value. And for small practices, with limited staff, this data clicking and extracting, clicking, uploading etc, falls on the MD, the data entry clerk of CMS. Just today, I had to do what seems simple, 2 MDs in the TKA measures groups (6 measures in it) for 20 patients. After uploading the specific order cvs file, I had to find 20 Medicare patients that had TKAs, then enter if they were Medicare patients for each of the 20, then if the performance was met for each of the 6 measures for each of the 20 patients. Quick math, that is 240 clicks for each MD after entering the Medical record numbers. So thanks Medicare for adding over 500 clicks to my already click happy day. Can you tell that we are bitter and angry about this? Does CMS REALLY think this improves care? Not a chance.
This is the same “self-reporting” BS that is PQRS.
You have to “extract” the data from your EHR, many times having to pay extra for this, or from a third party to do it. Get it into the format the registry wants, again, a charge.
Upload the data. The registry then churns through it and then gives any errors back to you.
then you have to pay someone to ENTER the data that the performance was met. AND then upload it back to the Registry, and hope that it is not in error some way or you get penalized, don’t forget the Registry charges a ton to upload the info to Medicare.
We are talking THOUSANDS of data points. Ridiculous. So tell me how does this “show” quality, when I report 6 and someone else reports a different 6 and the millions of combinations of that. Plus its all self-reported and NOTHING to do with outcomes. Only that you clicked a box. Congrats CMS, that is your BS value. And for small practices, with limited staff, this data clicking and extracting, clicking, uploading etc, falls on the MD, the data entry clerk of CMS. Just today, I had to do what seems simple, 2 MDs in the TKA measures groups (6 measures in it) for 20 patients. After uploading the specific order cvs file, I had to find 20 Medicare patients that had TKAs, then enter if they were Medicare patients for each of the 20, then if the performance was met for each of the 6 measures for each of the 20 patients. Quick math, that is 240 clicks for each MD after entering the Medical record numbers. So thanks Medicare for adding over 500 clicks to my already click happy day. Can you tell that we are bitter and angry about this? Does CMS REALLY think this improves care? Not a chance.
Tomorrow I have to do the other 2 MDs that are doing 9 measures across three domains and one cross cutting measure. Now that sounds like a ton of fun right? Thousands of clicks. Anyone listening CMS?
Our Sleep Practice ONLY performs the professional component of Service (26 modifier).
MACRA or MIPS reporting says you are a “qualified provider” based on your NPI#. the issue is that in our case we have no control over Quality initiatives in the office nor do we own the record to be able to pull information from a EHR or physical chart to satisfy any of these measures.
So the question I can not get answered by anyone at CMS is: “Will Provider NPI’s that only bill the professional component of service be exempt from MACRA payment reform and MIPS reporting standards/measures?”
I have reached out to everyone at CMS as well as my contacts at a state level. NO one seems to be able to help me?
Anyone out there have any suggestions or contacts that could assist?
Here’s another good question.
Do providers still have to report MU2/MU 3 and MIPS in 2017 and 2018?
They have very different competing measures.
What if you are still receiving bonus money? BTW Not asking for myself, but other MDs
that still can’t see the light of taking penalties vs torture of MU and MACRA data entry reporting nightmare.
CMS cannot answer this either.