What You Need to Know About 2019 MIPS Quality Benchmarks

January 30th, 2019 by

Some said it wouldn’t happen, but here we are. We are officially into the third year of MIPS and CMS continues to drive towards the full implementation of the program Congress envisioned when they passed MACRA in 2015. There is a lot of talk, and rightfully so, about the Promoting Interoperability (PI) and Cost categories as they have changed, expanded in scope, and become harder in 2019. As these two categories are consuming significant attention, organizations run the risk of losing focus on the Quality category which still contributes more to the overall MIPS score than any other category.

For the first time, the Quality measure benchmarks are based on the MIPS program, leveraging 2017 MIPS data as opposed to referring back to data from prior programs such as PQRS. Consistent with previous years, SA Ignite’s regulatory team conducted a detailed analysis of all 257 quality measures approved for 2019, across all submission types. Consistent with previous years, the analysis surfaced significant changes to the benchmarks that will impact the ability of individual clinicians and healthcare organizations to earn a high-quality score in 2019. This is why it is critical that healthcare organizations examine changes in the measures and benchmarks to determine which measures will align with organizational objectives and yield the highest MIPS incentives.

Watch this 10-minute clip from our January 2019 ABCs of the QPP webinar to learn more about MIPS Quality benchmark changes and what you can do to protect your MIPS score.

Access the full webinar here: Starting Strong in 2019

This analysis just scratches the surface. To really understand how these changes will affect your organization, a more detailed conversation is required. SA Ignite can help you understand where you may have some vulnerabilities with the changes in MIPS Quality benchmarks, as well as quantify the financial impact of the broader 2019 MIPS changes. Contact us for a MIPS consultation today.

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