MIPS: How do I improve my Quality score?

Your MIPS Quality score

The Quality component of MIPS is calculated through PQRS Clinical Quality Measures. Each measure is calculated as a percentage of measure-specific criteria found here. For each measure, there is:

  • A numerator component that describes patients that count toward improving your measure score
  • The patient population representing the denominator
  • Any exceptions that would exclude patients from falling under the calculation logic

Once the measure's percentage is calculated, the percentage will fall under a decile specified by CMS. What  decile the percentage falls to indicates the number of points you will get toward your Quality score.

Example:

  • Measure Calculation = 26/100 = 26%
  • 26% corresponds to decile 4 (24% - 36%) which awards a point spread of 4.0 - 4.9 points.
  • 26% is 2% higher than the base percentage of this decile (24%). If your measure percentage was 24%, the number of points awarded for this measure would be 4.0.
  • Since your score is 2% higher, you will be awarded a point value linearly proportional to the point range of the decile. Since this decile spans 12%, you will get 1%/12% = 0.16 points more than the base value, or 4.16 points toward your quality score.
  • Since Quality is weighted at 60% of your total MIPS score, your final point contribution would be 4.16 * 60% = 2.5 points.

We've made point calculations easy for you to understand by giving you the percentages you need in our MACRA/MIPS dashboard.Screen_Shot_2017-10-25_at_5.15.10_PM.png

 

Improving Your Score

STEP 1: Pick a measure and identify what percentage you need to hit. You can do this in our MACRA/MIPS dashboard.

Screen_Shot_2017-10-25_at_9.23.38_PM.png

STEP 2: Check our Clinical Quality Measures dashboard to see the current numbers for your numerator/denominator.Screen_Shot_2017-10-25_at_9.24.36_PM.png

STEP 3: Find the measure in our help center section and find out what specific actions/codes need to be done or added for a patient to be included in the numerator.

 

STEP 4: Make those changes and see your percentage and point score update.

 

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