Merit-based Incentive Payment System (MIPS)

Merit-based Incentive Payment System (MIPS)2018-09-01T00:28:35-04:00

Project Description

Take Control of Your MIPS Score!

Your 2018 MIPS score will adjust your 2020 Medicare Part B payment between -5% and +15%. Be among the winners by taking control of your MIPS score. Clinigence will help you maximize your score by providing guidance, technology and submission services. Hover over any of the check marks on the chart to learn more about each of these areas.

How can I maximize my MIPS score?
Am I required to participate in MIPS 2018?2018-06-28T01:22:35-04:00
  • Physicians (including doctors of medicine, doctors of osteopathy, osteopathic practitioners, doctors of dental surgery, doctors of dental medicine, doctors of podiatric medicine, doctors of optometry, and chiropractors)
  • Physician assistants
  • Nurse practitioners
  • Clinical nurse specialists
  • Certified registered nurse anesthetists
  • Groups or virtual groups that include one or more of the clinician types above

Clinicians or groups that have billed more than $90,000 in Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer)

2017 or earlier

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More Than Ever Quality Matters

Under MIPS 2018, quality counts for 50% of your performance score:

  • Remember you only need to report on 6 clinical quality measures (CQMs) out of a menu of dozens (EHR-based, aka electronic CQMs, or eCQMs).
  • Choose intelligently which measures to report by comparing your performance to CMS-published benchmarks.
  • Registry reporting extends the menu to hundreds of CQMs if needed. Clinigence is a 2018 certified registry.
  • As a CMS-approved Qualified Clinical Data Registry (QCDR), we also offer dozens of additional measures to choose from.
  • Continuously track your performance through the year to ensure no surprises at the end of the year.
  • Start early: quality improvement takes time and you cannot fix your performance retroactively.
  • Engage providers by delivering just-in-time information at the point of care.
Tell me more about improving my MIPS quality score
Which 2018 MIPS CQMs do you support?2018-09-07T01:06:16-04:00

Clinigence supports all EHR-based MIPS measures.

Clinigence supports all registry MIPS measures.

Anti-platelet Medication for High Risk Patients2018-06-28T02:16:08-04:00

The percentage of high risk patients who are prescribed an dication. High risk patients include those patients ages 50-69 years with ≥ 10% 10-year CVD risk

Avoiding Use of CNS Depressants in Patients on Long-Term Opioids2018-06-28T02:44:15-04:00

The percentage of patients on long-term opioid prescriptions without a concurrent prescription for an CNS depressant

Back Pain: Use of EMG & CNS2018-06-28T02:40:36-04:00

Percentage of patients with a diagnosis of axial lumbar, thoracic or cervical spine pain who had an electromyography (EMG) or nerve conduction study (NCS) within 30 days of the diagnosis

Cancer Patients – Survivorship Care Plan2018-06-28T02:41:27-04:00

Percentage of patients with an encounter for follow-up examination after completed treatment for malignant neoplasm who have a survivorship care plan documented on the same date

Chronic Kidney Disease (CKD): eGFR Monitoring2018-06-28T02:37:28-04:00

The percentage of adult patients with Stage 3 or 4 CKD who have had a eGFR or serum creatinine in the past 6 months

Chronic Kidney Disease (CKD): Hemoglobin Monitoring2018-06-28T02:38:33-04:00

The percentage of adult patients with Stage 3B-Stage 5 CKD who have had a serum hemoglobin measured in the past 12 months

Foot Bone Infection Diagnosis Without MRI2018-06-28T02:45:02-04:00

Percentage of patients with a diagnosis of bone infection (osteomyelitis) in the foot who had an MRI of the foot.

Goal Setting and Attainment for Cancer Survivors2018-06-28T02:42:22-04:00

Percentage of patients aged 18 years and older who completed the final component of cancer treatment that have at least one post-treatment goal documented and progress of goal attainment documented within 12 months of completing the final component of cancer treatment.

Monitoring Serum Creatinine2018-06-28T02:39:18-04:00

The percentage of adult patients prescribed an ACEI, ARB, digoxin, diuretic or metformin who have had a serum creatinine measured in the past 12 months

Morton’s Neuroma – Avoidance of Alcohol Injections2018-06-28T02:46:09-04:00

Percentage of patients with a diagnosis of Morton’s neuroma who received alcohol injections

NSAID or Cox 2 Inhibitor Use in Patients with Heart Failure (HF), Hypertension (HTN), or Chronic Kidney Disease (CKD)2018-06-28T02:07:31-04:00

The percentage of adult patients with HF, HTN or CKD who are not prescribed an NSAID or COX 2 inhibitor.

Screening for albuminuria in patients at risk for CKD (DM and/or HTN)2018-06-28T02:36:13-04:00

Test for albuminuria or urine protein in adults with Diabetes Mellitus or Hypertension and without CKD

Screening for Type 2 Diabetes2018-06-28T02:24:40-04:00

The percentage of patients 40 to 70 years of age who are overweight or obese and have been screened for type 2 diabetes in the past 3 years

Promoting Interoperability (PI)

This category, which accounts for 25% of your total MIPS score in 2018, should generally be covered by your EHR. In order to earn a PI score, you must use Certified EHR Technology (CEHRT). Clinigence can help you submit your PI data to CMS.

I need help with MIPS PI data submission

Improvement Activities (IAs)

To receive full credit for this category, choose 2 (practices with less than 15 providers) or 4 (practices with 15 providers or more) of the following activities supported by Clinigence:

  • Depression Screening
  • Diabetes Screening
  • MOD Prevention and Treatment Interventions
  • Measurement and Improvement at the Practice and Panel Level
  • Tobacco Use
  • Unhealthy Alcohol Use
I’m interested in MIPS IAs


In 2018, CMS calculates the cost component of your MIPS score based on claims. You do not need to submit any data. You may, however, wish to start building your capacity to manage the cost of care by integrating proven cost-reduction measures and risk score optimization tools in your practice’s workflow. Clinigence also offers a comprehensive suite of cost and utilization management tools that may be useful to you in future years.

What can I do to improve my MIPS cost score?

The Clinigence Value Improvement Process