On May 20, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that they will reweight the Cost performance category from 15% to 0% for the 2020 MIPS performance period for all MIPS eligible clinicians, regardless of participation as an individual, group, virtual group, or APM Entity.
This announcement comes in recognition of the impact of the COVID-19 public health emergency on cost data in 2020.
Specifically, CMS states that they do not believe they can reliably calculate 2020 Cost scores because of the following COVID-19 impacts:
-
A significant decrease in service utilization in 2020 demonstrates cost measures may not accurately characterize patient risk due to the lack of diagnosis information in the lookback periods used for risk adjustment.
-
Episodes with COVID-19 diagnoses generally have higher observed and risk-adjusted costs, indicating COVID-19 impacted service utilization and wasn’t sufficiently accounted for through risk adjustment.
-
The overall number of clinicians who met 2020 cost measure case minimums substantially decreased from prior performance years. A substantial portion of clinicians had episodes with COVID-19.
Important Notes:
- If you submit data on 1 or fewer MIPS categories, CMS will assign you a 2020 MIPS score equal to the threshold to avoid a penalty.
- The new category weights for 2020 MIPS are shown below
Next Steps
- Share this information with your practice colleagues.
- Contact your MarsdenAdvisors Client Success Manager if you have any questions.
If you have any questions on this, let us know!
