The MIPS Cost category weight is increasing to 20% of a clinician’s final MIPS score in 2021 and 30% in 2022. The increase reflects the priority that the Center for Medicare and Medicaid Services (CMS) has placed on controlling the cost of health care services as a component of the MIPS program. As Cost makes up a larger portion of the total MIPS score, it’s beneficial to understand how CMS measures Cost. Let’s review the basic components of the Cost category and examine strategies to manage and potentially improve performance.
Cost is the fourth performance category under the MIPS program and makes up 15% of your total MIPS score for 2019 (up from 10% in 2018 and 0% in 2017). This category will steadily increase to 30% by the year 2022 when it will have the same weight as Quality. If CMS is unable to calculate a Cost score for a clinician, the category will be reweighted to Quality. While clinicians can relatively quickly change their MIPS Quality score by tracking some specific outcomes (e.g., track smoking status and give cessation advice), Cost is more challenging. It is more complex with many different variables, so monitoring Cost becomes important as it contributes more towards your final MIPS score. MDinteractive can help you access your CMS performance feedback reports which will provide your Cost score from prior MIPS reporting years. In this article we will explore the different cost measures, how they are scored and the potential impact on your practice.