Quality performance category
- Select 6 measures
- 1 outcome or high-priority measure
- Alternatively, a specialty or sub-specialty measure set may be used
- Report 60% of applicable visits from a full calendar year
- Population measure automatically calculated, if applicable
Key Changes from 2018
Click each option to learn more!
Quality comprises 45% of the MIPS final score.
In 2018, Quality comprised 50% of the MIPS Final Score.
In 2019, Quality comprises 45% of the MIPS Final Score.
Small Practice Bonus of 6 points will be included in the Quality Performance Category.
In 2018, small practices with 15 or fewer providers had a small practice bonus of 5 points applied to their MIPS final score.
In 2019, the small practice bonus will be included in the Quality performance category score and increase to 6 points. Providers must submit data for at least 1 quality measure to receive this bonus.
Submit multiple types of quality measures.
In 2018, providers were required to report measures through 1 submission mechanism / collection type.
In 2019, providers can submit measures using multiple collection types (e.g. eCQM, QCDRs, and CQMs), and the one with the highest number of points will be used to determine your Quality score.
Topped out measures
Six measures were identified by CMS in 2018 as "topped out" and had their total possible points capped at 7 points instead of 10 points. There will be additional measures added to this list in early 2019. Starting in 2019, measures will be capped at 7 points if their benchmarks remain topped out for 2 consecutive years.
- #21: Perioperative Care: Selection of Prophylactic Antibiotic—First OR Second Generation Cephalosporin
- #23: Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)
- #52: Chronic Obstructive Pulmonary Disease (COPD): Inhaled Bronchodilator Therapy
- #224: Melanoma: Overutilization of Imaging Studies in Melanoma
- #262: Image Confirmation of Successful Excision of Image—Localized Breast Lesion
- #359: Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computerized Tomography (CT) Imaging Description
Quality Performance Category Submission Options
An organization may choose to submit measure data to CMS as an individual or as a group through any of the options below.
Clinical Quality Measures ( Formerly Qualified Registries)
Electronic Clinical Quality Measures (Formerly EHR Measures)
Medicare Part B Claims*
CMS Web Interface
CAHPS for MIPS Survey
*Medicare Part B claims measures can only be submitted by clinicians in a small practice (15 or fewer eligible clinicians) whether participating individually or as part of a group.
What Contributes to the Quality Performance Category Score?
As Quality is worth 45% of your total MIPS composite performance score, understanding how to excel in this category is important. Measure performance compared to benchmarks, bonus points, performance improvement, and the small practice bonus will all impact your Quality score.
- 1-10 Points per reported measure
- Add together points scored and divide by 60 or 70 (for groups eligible for the All-Cause Hospital Readmission measure) to get the final quality score.
- If less than 6 measures are selected, clinicians will receive 0 points for missing measures.
- Quality measures that meet the minimum case requirement (20 eligible instances), 60% data completeness threshold, and have a benchmark will be worth between 3-10 points.
- If a measure has no benchmark or does not meet the minimum case requirement, it will only receive 3 points. If a measure does not meet the data completeness threshold of 60%, it will only receive 1 point or 3 points (small practices).
- Bonus point categories are capped at 10% of the total possible quality score. This is 7 points for groups eligible for the All-Hospital Readmission Measure, and 6 points in all other circumstances.
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