Maximize Your Quality Performance Score in MIPS 2021

QPP MIPS 2021 is an incentive program that helps you cash on lots of financial opportunities. For instance, MIPS eligible clinicians can avoid penalties of up to 9% as CMS (Centers for Medicare and Medicaid Services) has made it compulsory for every clinician to participate in this program.

Failure to submit data cab lead clinicians to incur the penalty but also lose the opportunity to earn incentives.

A Background to MIPS 2021 Quality Requirements

MIPS is one of its kind programs accessible to MIPS qualified clinicians for gathering and revealing information about their value-based healthcare services. Today, we will talk only about the Quality category that estimates medical care cycles, results, and patient encounters in general.

Quality Caters to 40% of Final Score 

This percentage change almost every year because of Exception Applications or Alternative Payment Model (APM) Entity investment.

Clinicians can consult MIPS consultants to demonstrate the true potential of their performance to CMS. 

Moreover, for general details, you can read this article. 

What Quality Data Should I Submit?

• There are 6 assortment types for MIPS quality measures

• Electronic Clinical Quality Measures (eCQMs)

• MIPS Clinical Quality Measures (CQMs)

• Qualified Clinical Data Registry (QCDR) Measures

• Medicare Part B claims measure

• CMS Web Interface measures

General Detailing Prerequisites for MIPS 2021 Data Submission (for those not revealing through the CMS Web Interface)

You'll ordinarily have to submit gathered information for no less than 6 measures (counting 1 result measure or high-need measure without an applicable outcome measure), or a complete measure set.

You'll have to report data for basically 70% of the patients who fit the bill for each action.

You can submit measures from various collection types (except CMS Web Interface measures) to satisfy the prerequisite to report at At least 6 quality measures.

CMS will compute and score the performance of individuals, groups, and virtual groups on 2 new regulatory case estimate when the individual, groups, or virtual groups meets the case least, and clinician the necessity for the measure

Medical clinic Wide, 30-Day, All-Cause Unplanned Readmission (HWR) The rate for the Merit-Based Incentive Payment Program (MIPS) Eligible Groups (This action is supplanting the All-Cause Hospital Readmission (ACR) measure, Quality ID 458).

Hazard normalized Complication Rate (RSCR) following Elective Primary Total Hip Arthroplasty (THA) as well as Total Knee Arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS).

How Are Measures Scored?

CMS decides to measure MIPS 2021 performance based on measure performance as per the benchmark.

If an action can be dependably scored against a benchmark, it for the most part implies:

• A benchmark is accessible.

• Has no less than 20 cases.

• The data fulfillment standard is for the most part 70%.

CMS Web Interface measures are scored against the Shared Savings Program benchmarks.

Criteria for Bonus Points

• You can acquire quality extra focuses in the following manner.

• Submit at least 2 results or high-need quality measures.

• This reward isn't accessible for the first, the required result, or high-priority quality measure.

This reward isn't accessible for measures needed by the CMS Web Interface, however, is accessible to MIPS eligible groups that report the CAHPS for MIPS overview notwithstanding the CMS Web Interface measures.

The Easy Formula for Maximizing MIPS Quality Performance Score

What you should and shouldn’t do to maximize your MIPS Quality score is mentioned above. But a detailed formula is given below to help strategize accordingly.

Select Only the Best Specialty-Specific MIPS Quality Measures

When you or your MIPS Qualified Registry is in the measure selection phase, make sure you select more than 6 measures to report to the CMS.

Earn Up to 10% of Bonus on the Quality Score with CEHRT Bonus

If MIPS eligible clinicians go for end-to-end MIPS reporting 2021, they are qualified for 10% of the MIPS bonus concerning the CEHRT bonus. It means that you can earn 1 point per submitted measure.

Performance Benchmark Requirement

QPP MIPS quality measures that do not come with a performance benchmark do not grant more points than 3. 

Data Completeness Rule

For MIPS 2021 data submission, eligible clinicians must fulfill the data completeness rule. You are required to submit 70% of the data complied with the eligible cases.

Small medical practices have the flexibility that even if they don’t meet the data completeness rule, they still can receive 3 points for each MIPS Quality measure. However, this option is not valid for large or established medical practices.

Case Minimum Requirement

To maximize performance in the MIPS quality category in 2021, clinicians must meet the case minimum criteria of 20 cases per MIPS quality measure. Only this way, you can receive more than 3 points per measure.

Use the certified version of EHR innovation (CEHRT) to gather measure information and meet the electronic reporting requirements.

Six extra bonus points are added to the quality performance score for clinicians in little practices who submit 1 measure, either exclusively or collectively or in virtual groups. This reward isn't added to clinicians or gatherings who are scored under facility-based scoring.

You can likewise target up to 10 extra rate focuses dependent on your improvement in the quality performance from the previous year. You can also consult MIPS Qualified Registries for streamlined MIPS reporting.