MIPS 2022 Quality and Cost Performance Categories

As a qualified CMS registry for an 11th consecutive year, the team at HCIS believes in the importance of updating you with relevant information for the upcoming MIPS reporting year. If you attended our last webinar, the team shared important information on the Quality and Cost Performance Categories. If you missed it, here are some highlights from the presentation: 

Quality Performance Category 

The Quality category assesses the quality of care a provider delivers and is measured by the provider’s quality measures score. Scores are determined based on performance related to healthcare processes, outcomes, and patient-care experiences. Important steps to remember for reporting data include understanding reporting requirements, choosing which measures to report on, collecting data, submitting data, and reviewing CMS performance feedback. One tip to remember when working through this process includes choosing measures that are already being tracked in your groups’s Electronic Medical Record (EMR) to avoid manual data collection. 

Cost Performance Category 

The Cost category is an integral part of the MIPS scoring system. While clinicians do not set the price of individual services, they do affect the frequency of services rendered and which types are provided. With improved care coordination and services management, clinicians can improve health outcomes, ensuring their patients receive the right services at the right times. To do this, organizations need to understand cost category measures. The first is the Medicare Spending Per Beneficiary Clinician (MSPB), which involves the cost of care for services related to a qualifying inpatient stay. Second is the Total Per Capita Cost (TPCC) this population-based measure assesses the overall cost of care delivered to a Medicare recipient with a focus on primary care.  

The cost category also includes 15 procedural episode-based measures which assess the cost of care as related to a specific procedure administered during the episode time frame. There are 6 acute inpatient medical condition episode- based measures which assess the cost of care clinically related to specific acute inpatient medical condition also provided during an episode’s time frame. Finally, there are 2 chronic condition episode-based measures that assess the cost of care clinically related to the management of patients’ specific chronic condition provided during a total attribution window divided into episodes. 

HCIS can help you get started today. 

While this information may seem complex, know that the team at HCIS can help you disseminate and understand all the complexities of the MIPS program. We have helped thousands of providers avoid penalties and receive positive payment adjustments. 

Contact us today to learn more and be sure to sign up for our upcoming webinars to learn more about MIPS reporting and the other HCIS offerings available to your organization.