The cost performance category for the 2020 MIPS program will be reweighted to 0 percent, according to an announcement from the Centers for Medicare and Medicaid Services (CMS) last week. The change is part of CMS’s COVID-19 flexibilities for the Merit-based Incentive Payment System that span 2019, 2020, and 2021.
CMS said they considered three different factors in making this decision. First, the volume of 2020 performance year data available to calculate the scores for cost measures significantly decreased compared to prior years. Also, care episodes related to COVID-19 diagnoses had higher observed and risk-adjusted costs on average. Finally, the overall number of clinicians who met 2020 cost measure case minimums substantially decreased from prior performance years.
“As a result, we do not believe we can reliably calculate scores for the cost measures that would adequately capture and reflect the performance of MIPS eligible clinicians,” CMS said in their announcement about the change.
The 15 percent performance category weight will be redistributed to other performance categories, with 10 percent going to the quality category and 5 percent going to the promoting interoperability category under normal scenarios. If a provider receives reweighting based on other policies, the reweighting may be redistributed differently. Here’s a look at the various possibilities:
|MIPS Performance Category Reweighting Scenario||Quality Category Weight||Cost Category Weight||Improvement Activities Category Weight||Promoting Interoperability Category Weight|
|No Additional Reweighting Applies||55%||0%||15%||30%|
|No Promoting Interoperability, No Cost||85%||0%||15%||0%|
|No Quality, No Cost||0%||0%||15%||85%|
|No Improvement Activities, No Cost||70%||0%||0%||30%|
Clinicians don’t need to take any action as a result of this decision because the cost performance category relies on administrative claims data.
For more information about CMS’s COVID-19 flexibilities, check out the Quality Payment Program COVID-19 Response webpage.
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