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  • MIPS 2021—Quality Scoring: Some Benchmarks Are “Flat”

    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.

    Previous: Quality Scoring: Some Benchmarks Are Subject to Scoring Limitations

    Next: Quality Scoring: Bonuses for High-Priority Measures and CEHRT 

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