The Merit-based Incentive Payment System (MIPS) is the structure that determines Medicare payouts. Clinicians or practices receive scores based on reported performance over four categories, including quality. The goal is to reward clinicians for better patient care.
The program has fairly demanding reporting requirements, and the specifics are updated annually based on policy changes. In 2023, the general obligations are the same:
- Quality measures are worth 30% of your score for individuals, groups, and virtual groups
- You must report data for at least 70% of the eligible cases
- You must collect data for one of the following:
- At least six measures over 12 months OR
- At least one of the six must be an outcome measure or a high-priority measure
- You must report on a complete specialty set
However, there are a few new changes to the MIPS 2023 quality measures, including new and removed options and new scoring rules.
1. 8 New MIPS 2023 Quality Measures
In 2023, there are 198 measures to choose from, some of which are used only for specialties. CMS added eight new standards to the inventory, including dermatology standards and one automatically calculated admin claim measure.
The new MIPS 2023 quality measures are as follows:
- 485: Psoriasis: Improvement in Patient-Reported Itch Severity
- 486: Dermatitis: Improvement in Patient-Reported Itch Severity
- 487: Screening for Social Drivers of Health
- 488: Kidney Health Evaluation
- 489: Adult Kidney Disease: ACE Inhibitor or Angiotensin Receptor Blocker Therapy
- 490: Appropriate Intervention of Immune-Related Diarrhea and Colitis in Patients Treated with Immune Checkpoint Inhibitors
- 491: Mismatch Repair or Microsatellite Instability Biomarker Testing Status in Colorectal Carcinoma, Endometrial, Gastroesophageal, or Small Bowel Carcinoma
- 492: Risk-Standardized Acute Unplanned Cardiovascular-Related Admission Rates for Patients with Heart Failure under MIPS
- *Admin claim
- 493: Adult Immunization Status
When you report under the traditional MIPS, the new adult immunization status benchmark will include shingles, tetanus combo, influenza, and pneumococcal vaccinations.
2. 11 MIPS 2023 Quality Measures Removed
CMS also removed several standards for 2023, which means you can no longer report on these options throughout the year. Some are electronic quality measures or Medicare Part B claims, while others are clinical.
Removed quality measures for 2023 include:
- 076: Prevention of Central Venous Catheter Bloodstream Infections
- 119: Diabetes: Medical Attention for Nephropathy
- 258: Rate of Open Repair of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms without Major Complications (Discharged to Home by Post-Operative Day #7)
- 265: Biopsy Follow-Up
- 323: Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention
- 375: Functional Status Assessment for a Total Knee Replacement
- 425: Photo documentation of Cecal Intubation
- 455: Percentage of Patients Who Died from Cancer Admitted to the ICU in the Last 30 Days of Life
- 460: Back Pain After Lumbar Fusion
- 469: Functional Status After Lumbar Fusion
- 473: Leg Pain After Lumbar Fusion
Additionally, CMS removed two other standards from the traditional MIPS reporting, which will still be available for the MIPS Value Pathways (MVP). These two partial removals include:
- 110: Preventive Care and Screening: Influenza Immunization
- 111: Pneumococcal Vaccination Status for Older Adults
3. New Scoring Based on Benchmarks
CMS benchmarks measure inventory for two or more years before the reporting period starts. You receive 5-10 points based on your performance compared to this baseline. For example, for the 2023 period, CMS will compare your data against data reported in 2021 for those same measures.
New in 2023, CMS will now benchmark measures three years or older. You will receive 1-10 points for these measures, so long as you meet a few criteria, including:
- Case minimum, usually 20 cases
- Data completeness of reporting for 70% or more cases
- The selected measure doesn’t cap at 7 points
All reporters except small practices will receive zero points for incomplete data in Medicare Part B claims. If you are a small practice, you will receive three points.
There are some new changes for measures without a benchmark. For 2023, you’ll earn zero points for measures three years or older and that can’t score against a benchmark. Small practices will earn three points.
MIPS Success With ChartPath
Staying up-to-date on CMS changes to MIPS each year is somewhat of a feat. Hands down, electronic reporting and data collection is the best way to keep up with reporting requirements. Rather than scrambling to catch up on your reporting and new measures, you can monitor your performance against touch tones throughout the year.
With EHR software like ChartPath, you can track your MIPS 2023 quality measures from a central dashboard and adjust as you go. At the end of the year, submit your final report with one click. For easier practice management and MIPS success, learn more about reporting with ChartPath.