MIPS Highlights

Quality Payment Program Year 7: MIPS Highlights

  • Performance threshold remains at 75 points
  • Data completeness remains at 70%
  • Exceptional performer threshold was removed
  • Positive and/or negative payment adjustment could be between 0-9%
  • EHR needs to be certified to the 2015 Edition Cures Update
  • Updates to measure reporting requirements for the Promoting Interoperability performance category
  • Discontinuance of automatic reweighting for certain clinician types
  • Modified Promoting Interoperability measures and reporting requirements
  • PDMP measure is not a required measure under Promoting Interoperability
  • Added 3rd option for satisfying HIE objective
  • Adjustments to measure points under Promoting Interoperability
  • Establishing a maximum cost improvement score of 1 percentage point (out of 100 percentage points) for the cost performance category
  • Expanding the definition of “high priority measure” to include health equity-related quality measures
  • Reduction of quality measure inventory from 200 to 198 (removed 11 and added 9 MIPS quality measures)
  • Substantive changes to 76 existing MIPS quality measures
  • Scoring of new Administrative claims-based quality measures
  • Revisions to the CAHPS for MIPS Survey case-mix adjustment
  • Added 4 new Improvement Activities, modified 5 existing activities, and removed 6 existing improvement activities
  • Modified how the 50 eligible clinician limit is applied to Medical Home Models
  • Removed the 2024 expiration of the 8% minimum on the Generally Applicable Nominal Risk standard for Advanced APMs and making the 8% minimum permanent.
  • Introduction of MVPs

For more information on the Quality Payment Program Year 7 Final Rule click here.

CMS will automatically calculate and score 4 administrative claims measures for individuals, groups, virtual groups, and APM Entities when such measures are applicable and the individua, group, virtual group, or APM Entity meets the case minimum and clinician requirement for the measures.