This content is excerpted from EyeNet’s MIPS 2021; also see the Academy’s MIPS hub page.
CMS has applied flat benchmarks to these two measures:
- Measure 1: Diabetes: Hemoglobin A1c (HBA1c) Poor Control (>9%). Measure 1 has a flat benchmark when reported by Medicare Part B claims but not when reported via the IRIS Registry.
- Measure 236: Controlling High Blood Pressure. Measure 236 has a flat benchmark when reported by claims or manually via the IRIS Registry but not when reported via IRIS Registry–EHR integration.
What is a flat benchmark? Most benchmarks are based on historic performance rates. By contrast, flat benchmarks are based on a simple formula.
When an inverse measure (e.g., measure 1) has a flat benchmark, 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.
For a flat benchmark that isn’t an inverse measure, 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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