Excerpted from “MIPS 2024, Part 1—What’s New With Quality" (EyeNet, January 2024), posted online ahead of print.
Your Medicare Part B payments in 2026 may be adjusted up or down depending on your 2024 MIPS final score.
MIPS final score. As in past years, your MIPS final score (0-100 points) is a composite score. It is based on your scores in up to four performance categories, which will have the same default weighting in 2024 as they did in 2023:
- quality score (default weight: 30%);
- promoting interoperability (PI) score (default weight: 25%);
- improvement activities score (default weight: 15%); and
- cost score (default weight: 30%).
What the weights mean. If your quality score is weighted at 30%, it can contribute up to 30 points to your MIPS final score: e.g., a quality score of 50% would contribute 15 points (50% of 30 points).
Weighting can be adjusted. Suppose, for example, you are scored on quality, PI, and improvement activities but don’t meet the case minimum for any cost measures. In that case, cost’s weight would be reduced from 30% to zero, while quality’s weight would be increased from 30% to 55% and PI’s weight would be increased from 25% to 30%.
How to avoid a penalty. As in 2023, you need to score at least 75 points to avoid a penalty and at least 18.76 points to avoid the maximum –9% penalty. If you score more than 75 points, you will receive a performance bonus.
Performance periods. The performance period for PI has increased from 90 days to 180 days. The performance period for the three other performance categories remains the same: 90 days for most improvement activities and the full calendar year for quality and cost measures.
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