Clinical Quality Measures - Why Accuracy Matters

The Quality Performance Category of the Merit-based Incentive Payment Program counts for 60% of your final score. You accumulate points for each measure based on your performance compared to the benchmark of others that submitted via the same method last year in PQRS. Let’s look at some examples:

Controlling High Blood Pressure – QID 236 (EHR Submission)

If my performance score is 59%, I would only get 4 points instead of 5.

Preventive Care and Screening: BMI and Follow-Up – QID 128 (EHR Submission)

If I have been following up all year, but couldn’t get patients to count in the numerator because I was not following a prescribed workflow, my numbers are not accurate and I am losing points. Perhaps my reported percentage is 0, when I know it should be at least 50%. That is a difference of 6 points. It is possible to report accurate numbers even if you didn’t use the correct workflow.

Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan – QID 134 (EHR Submission)

Did you copy the depression screening tool and impact the number of patients in your denominator? Again, it isn’t too late to get accurate numbers to report to CMS.

The accuracy of the data you submit directly impacts the number of points you receive which directly impacts the positive reimbursement you could be eligible for in 2019.

It isn’t too late in the year to get accurate data or to get a final score above 70, putting you in the exceptional performer tier of eligible clinicians that will share in the 500 million allocated for disbursement in 2019.


Do you have confidence in your numbers?

Do you know what your final score is?

We can help you with both of these if needed!