The CMS emailed updated 2021 quality benchmarks on June 11, 2021. In spite of the changes, this blog post will offer advice on how to improve your quality reporting in 2021. It will also give an overview of quality benchmarks and the effects of recent modifications. We will also go over these modifications and how they will change your procedure for quality improvement in 2021.
Quality Standards Explained.
Your performance score in the MIPS Quality Category is based on benchmarks. In order to divide performance into deciles, CMS uses performance from the two years preceding to the reporting period. Your score for the measure is based on the decile that corresponds to your performance during the reporting year. Let’s say you estimate that your performance on the Pneumococcal Vaccination Status for Older Adults measure will be 84% in 2021. An illustration of the CMS Quality Benchmarks for this measure is shown in the chart below (CMS 111).
For 2021, when reporting using the Direct EHR (eCQM) Collection Type, a performance of 85% will net you at least 9 points (with a range of 9–9.9). Benchmarks enable you to make well-informed choices concerning the calibre of your reporting. The benchmarks might assist in identifying your reporting score as well as the most advantageous reporting method.
Your provider(s) will receive 9 points for reporting the measure as an eCQM, according to the chart above once again. However, the same performance rate would only get you 8 points if they reported the measure through a registry (MIPS CQM collection type), making Direct EHR reporting the preferable choice in this scenario. Therefore, it’s critical to comprehend the benchmarks and apply them as a tool to help you maximise your quality score.
Recent Changes’ Effects.
These modifications were released, according to CMS’s June 11 email, to fix a mistake with the decile margins. In essence, all of the margins in their initial publication of the 2021 benchmarks were off by one decile. Your performance rate for each measure will be one decile lower than you anticipated if you were monitoring your quality performance using the original benchmark file. According to CMS, they wanted to be open and honest about the mismatch and take ownership of the first file’s inaccuracy.
It is significant to highlight that there are a number of quality indicators for which 2021 benchmarks are not available. A measure can only receive a maximum of 3 points if it doesn’t have a standard for 2021. (plus any applicable bonus points).
Optimizing Your Quality Report for 2022.
It is crucial to be aware of the actions you may take and the resources at your disposal when you start the second half of the reporting year in order to maximise your quality performance score. Here are some ideas to think about:
Benchmarks can be downloaded and reviewed from the QPP Resource Library.
As previously mentioned, keeping track of your performance and project score throughout the year will help you pick which measurements to report with knowledge.
Recognize that you can submit reports for several collection types.
You can report certain metrics from the registry and some from your EHR for clients who also use registries to report quality. The six best-performing metrics from among the many submission options (such as Direct EHR, Registry, or Claims) will be given to you by CMS (for small practises only).
Ask for assistance from Regulatory Experts
Ask your EHR vendor whether they have a team of specialists who can assist you in routinely reviewing your performance and putting you on the best path to greater performance for 2021.
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