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  • Jesse Arnoldson

Goals for MIPS Quality: What are Yours Based On?


If you have been working hard and staying ahead of the rest of the nation then by now you are probably monitoring your practice’s performance on its MIPS Quality measures. Perhaps you are even starting to use data to coach improvement amongst your providers. However, do you know where the finish line is that you are coaching them to? Do you know what percentage you need to reach for each individual measure? If you were to score a 98%, what does that even mean? Depending on the measure it means the difference of scoring ten points for one and four for another.

The answers to those questions are not complete unknowns; nevertheless, they are somewhat difficult to work through. What all of these points add up to is data, benchmark data published by CMS to be exact. Back in December, CMS published benchmarking data for the majority of measures allowed under MIPS. This data included information on whether or not a measure is topped out or high priority and how to score performance for most measures.

Best practice should be that we evaluate benchmark and decile data and set a goal for each measure the best we can. For example, performing at an 83% on measures 47 and 236 would still allow for a score of approximately nine points and so a reasonable performance goal could be 90%. In looking at measure 130 though, a 90% would earn you no more than four and a half points making 100% the likely goal to aim for.

Not knowing where the finish line is in this race is a dangerous game to play. Utilize the resources we’ve been given and don’t shy away from asking for help.