Cost performance category
2019 MIPS
- 10 measures, including 2 overall primary care measures and 8 new episode-based measures, are automatically captured through claims data.
- Total Category Score is averaged from the score of all applicable measures.
- Measure performance is tracked over a full calendar year.
- Clinicians can preview 2018 performance in July of 2019, and 2019 performance in Summer of 2020. MIPSPRO Enterprise members are able to receive this information quarterly.
Key Changes From 2018 Cost Reporting
- In 2018, Cost comprised 10% of the MIPS Performance Score and Quality comprised 50%. For 2019, the final score weighting has been adjusted so that Cost has a 15% weight and Quality has a 45% weight.
- Eight episode-based measures will now be a part of the Cost performance category score.
Cost Final Score
To calculate Cost, CMS will assign 1 to 10 achievement points to each scored measure shown in the table below, based on the clinician or group’s performance compared to the performance year benchmark. Therefore, achievement points for each measure depend on which decile range you or your group’s performance falls in.
The maximum score for the category is 100%. Additional bonus points will not be applied to a perfect achievement score.
Measure Topic | MEASURE TYPE | MINIMUM CASE VOLUME |
|---|---|---|
Medicare Spending Per Beneficiary (MSPB) | n/a | 35 |
Total per Capita Cost | n/a | 20 |
Elective Outpatient Percutaneous Coronary Intervention (PCI) | Procedural | 10 |
Knee Arthroplasty | Procedural | 10 |
Revascularization for Lower Extremity Chronic Critical Limb Ischemia | Procedural | 10 |
Routine Cataract Removal with Intraocular Lens (IOL) Implantation | Procedural | 10 |
Screening/Surveillance Colonoscopy | Procedural | 10 |
Intracranial Hemorrhage or Cerebral Infarction | Acute Inpatient Medical Condition | 20 |
Simple Pneumonia with Hospitalization | Acute Inpatient Medical Condition | 20 |
ST-Elevation Myocardial Infarction (STEMI) with Percutaneous Coronary Intervention (PCI) | Acute Inpatient Medical Condition | 20 |
Cost 2019
Cost 2019 Tracking software is the next big thing in Cost performance tracking and optimization.
Drill into your data.
Look at data by quarter or across multiple quarters. Compare by TIN, by measure, or compare data from past years with current measures. Our tracking software lets you view your data from any angle so that you have the full story.
Integrate to match your needs.
With our adaptable solutions, you can choose to track Cost separately--or link that data to your MIPSPRO account so you can view your big picture from one secure, user-friendly dashboard.
Optimize your score & your practice.
CostPRO 2019 helps you understand how much and where to spend on each patient, empowering you to optimize your business decisions based on CMS policy and best practices.
Reach out today to learn what CostPRO 2019 can do for your bottom line.
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