MIPS 2020—Quality Scoring: Some Benchmarks Are “Flat”

This content is excerpted from EyeNet’s MIPS 2020; also see the Academy’s MIPS hub page.

New for 2020: CMS introduced “flat” benchmarks. CMS has applied flat benchmarks to two measures:

• Measure 1: Diabetes: Hemoglobin A1c (HBA1c) Poor Control (>9%)  has a flat benchmark when reported by claims or manually via the IRIS Registry, but now when reported via IRIS Registry-EHR integration.
• Measure 236: Controlling High Blood Pressure has a flat benchmark for all three collection types.

What is a flat benchmark? Most benchmarks are based on historic performance rates. By contrast, flat benchmarks are based on a simple formula.

For measure 1, a performance rate of 10% or less earns you 10 achievement points; a performance rate of 10.01%- 20% earns you 9 achievement points, etc. (Measure 1 is an inverse measure, meaning that a lower performance rate represents a superior performance.)

For measure 236, a performance rate of at least 90% earns you 10 achievement points; a performance rate of 80%- 89.9% earns you 9 achievement points, etc.

Why did CMS introduce flat benchmarks? CMS was con­cerned that using the standard performance-based bench­marks for measures 1 and 236 may have motivated clinicians to reduce blood sugar or blood pressure to levels that might be too low for patients with certain medical conditions.

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