• MIPS 2018—Cost: 5 Quick Facts

    Written By: Chris McDonagh, Cherie McNett, and Jessica Peterson, MD, MPH

    This content was excerpted from EyeNet’s MIPS 2018; also see the Academy’s MIPS hub page

    No reporting requirements. CMS will evaluate you based on Medicare claims data for patients that it attributes to you.

    CMS will evaluate your performance either at the virtual group level, group level, or individual level. You will be scored at the same level for all 4 performance categories.

    You will be scored on up to 2 measures. You will be scored on the Total Per Capita Cost measure and the Medicare Spending Per Beneficiary measure, provided you meet their 20-patient and 35-episode case minimums, respectively.

    The performance period for cost is a full calendar year. Cost and quality both have a 12-month performance period, while ACI and improvement activities have a 90-day performance period.

    Your cost score contributes up to 10 points to your MIPS final score. However, if you fail to meet the case minimum for both the Total Per Capita Cost measure and the Medicare Spending Per Beneficiary measure, your performance categories will be reweighted, with those 10 potential points being shifted to quality (see Table 3: Reweighting the Performance Categories).


    Previous: Cost: A Potential Way to Track Resource Use: Clinical Data Registries.

    Next: Bonuses and Penalties: Your 2018 MIPS Final Score Will Impact Your 2020 Medicare Reimbursement.

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