• MIPS 2018—Quality: Watch for Measures That Don’t Yet Have Benchmarks

    Written By: Rebecca Hancock, Flora Lum, MD, Chris McDonagh, Cherie McNett, Jessica Peterson, MD, MPH, and Sue Vicchrilli, COT, OCS

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


    When you perform a measure in the quality performance category, you can earn up to 10 acheivement points, depending on how your performance rate compares against a benchmark.  For the 2018 performance year, a quality measure’s benchmark will typically be based on performance data from 2016. However, if there is no historic benchmark, and CMS is not able to set one based on 2018 data, you won't be able to earn more than 3 achievement points for the measure.

    Why some measures don't have a historic benchmark. In some cases—particularly with QCDR measures—the measure didn’t exist in 2016; in others, where wasn’t enough performance data in 2016 to set a meaningful benchmark.

    If a measure lacks a 2016 benchmark, CMS will try to set one based on data from the 2018 performance year. However, CMS won’t assign a benchmark to a measure unless the performance data include a minimum of 20 individual clinicians or groups that met the 2 data submission thresh­olds and had a performance rate greater than zero. 

    Note: If a measure does not yet have a benchmark, there is a chance that, even if a benchmark is developed, the measure might be topped out—which would limit your ability to score highly.

    Why you should report the QCDR measures. Although the QCDR measures don’t yet have benchmarks, they still have a role. Report QCDR measures as extra measures, in addition to 6 measures that have benchmarks. You earn high-priority bonus points for most QCDR measures, and your reporting may help to establish benchmarks for them.

    Which measures lack a benchmark?  Table 11 (PDF) provides an at-a-glance guide to the quality measures, including which measures lack a benchmark, which measures have benchmarks that are topped out (and at which decile), and which measures can earn you high priority bonus points. In that PDF, you can click on measure titles to access detailed web pages for those measures.

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    Previous: Quality: Your Performance Rate Will Be Compared Against a Benchmark.

    Next: Quality: Watch for Measures That Are Topped Out.

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