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.
- 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.
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.
STEP 2: Check our Clinical Quality Measures dashboard to see the current numbers for your numerator/denominator.
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.