Field testing offers preview of MIPS cost category -- in 2019 perhaps

by Richard Scott on Oct 20, 2017
You can buckle up and take part in a test run of the merit-based incentive payment system's (MIPS) cost category to see how your practice performs on eight experimental measures.
 
The experience may familiarize you with the cost category, which is something of a sleeping giant. Currently not tied to MIPS scoring for the 2017 and proposed 2018 performance periods, the cost category -- which assesses overall patient charges as well as, potentially, episode-specific charges -- is scheduled to awaken in 2019 and make up 30% of one's total performance score that year.
 
CMS' field testing of the eight episode-based cost measures is a voluntary program that's open to all providers and practices that meet the mininum requirements for at least one of the following measures:
  • Elective Outpatient Percutaneous Coronary Intervention (PCI)
  • Knee Arthroplasty
  • Revascularization for Lower Extremity Chronic Critical Limb Ischemia
  • Routine Cataract Removal with Intraocular Lens (IOL) Implantation
  • Screening/Surveillance Colonoscopy
  • Intracranial Hemorrhage or Cerebral Infarction
  • Simple Pneumonia with Hospitalization
  • ST-Elevation Myocardial Infarction (STEMI) with PCI
Remember that these measures are not contributing to your MIPS score during the 2017 or the proposed 2018 performance periods. Rather, "these measures are being field tested before consideration of their potential use in the MIPS cost performance category in a future year," states a CMS fact sheet.
 
Currently, the MIPS cost category measures just two items -- Medicare spending per beneficiary and total per-capita cost -- although the results do not affect MIPS scores because cost was given a 0% weghting in 2017 (and the same 0% weighting was proposed for 2018). The overall spending results are similar to the cost measures you can find in the quality use and resource reports (QRURs) that CMS provided under the sunsetting physician quality reporting system (PQRS) program.
 
Analyzing your practice- or provider-specific QRUR can shed light on your cost performance, and the episode measures under the field-testing program may provide a clue as to the future direction the cost category and what CMS may be measuring in future years.
 
For those interested in field testing, CMS is seeking comments on the episode-based measures no later than Nov. 15. If you receive measure results, which you can find on the CMS Enterprise Portal, you can submit your thoughts and opinions on the measures and documentation via an online survey.
 
Check out page three of the CMS fact sheet for the questions they're interested in exploring, and access a FAQ file for more information.
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