In 2024, all eligible clinicians are required to report in the MIPS program or face a 9% reimbursement penalty on Medicare Part B claims. As CMS continues to make changes to the penalty and scoring threshold, striving for high scores is crucial.

MIPS scoring consists of quality, cost, improvement activities, and promoting interoperability components. In this article, the quality component will be the main focus.

What’s New?

Within MIPS, the quality portion of reporting requires that any eligible clinician or group report on 6 different quality measures. The changes, however, can be found in the scoring of this component:

• Achieving bonus points for anything has been essentially eliminated for practices with more than 15 providers. Small practices will still receive a 6 point bonus just for reporting quality measures. Small practices also receive 3 points just for reporting a measure even if they did not meet any of the specified criteria.
• Larger practices no longer have a bottom line of 3, they can now receive a 0.
• Of the199 available measures, some have multiple reporting options, some have only one option.
• More than 50 measures have a 7 point earning cap even with perfect performance.
• 3 quality measures are now only available for MVP reporting.

The importance of measure selection cannot be overstated. Understanding the reporting options and choosing the best options for your practice are key elements to successfully achieving the maximum score possible. Below are some more changes for 2024:

Quality Measure Benchmarks

The quality measure benchmarks are used as a form of comparison in scoring quality measures. Each measure’s performance is evaluated against a benchmark to determine the amount of points earned - earning between 1 and 10 points.

To ensure each benchmark is established accurately, historical data is used when possible. If no historical data is available, then benchmarks are determined by CMS at the end of the performance year when all reported data has been collected.

Selecting the Right Quality Measures for You

Dedicating time to create a quality measure selection strategy is critical to achieving a high MIPS score in the future. Understanding the nuances that differentiate each measure from the next and using guidance from a Qualified Registry, like Quantician can help identify which measure to choose. Utilizing MVPs and MVP subgroups can reduce the required number of quality measures to four and potentially help optimize your score, however benchmarks might be harder to achieve.

Determining the trade-offs between each measure and reporting option can help develop an organized outlook on quality measures and optimize your MIPS score. Adapt your strategy to the changes that come with every year and schedule a demo with Quantician today.