Bonus points awarded when MIPS quality submission doesn't meet minimum requirements
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bin...@athenahealth.com
Dec 8, 2017, 2:05:29 PM12/8/17
to Developer Group for QPP APIs
We recently submitted MIPS quality data with 7 measures containing zeros in all denominators. This doesn't meet minimum reporting requirements, so we expected to receive scores of zero, but the scores returned awarded the provider 6 points. These appear to have originated from bonus points for end to end reporting, but we were under the impression that bonus points wouldn't be applied in this scenario.
Is this the expected scoring behavior or a bug?
steven....@semanticbits.com
Dec 8, 2017, 2:29:38 PM12/8/17
to Developer Group for QPP APIs
Godo Afternoon,
Would you mind posting the submission?
bin...@athenahealth.com
Dec 8, 2017, 3:04:54 PM12/8/17
to Developer Group for QPP APIs
Sure,
And the response:
Here's the request payload:
{ "nationalProviderIdentifier": "0000000001", "entityType": "individual", "measurementSets": [ { "measurements": [ { "measureId": "317", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "128", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "113", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "236", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "117", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "001", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } }, { "measureId": "204", "value": { "eligiblePopulation": 0, "eligiblePopulationException": 0, "eligiblePopulationExclusion": 0, "performanceNotMet": 0, "performanceMet": 0, "isEndToEndReported": true } } ], "submissionMethod": "electronicHealthRecord", "performanceEnd": "2017-12-31", "category": "quality", "performanceStart": "2017-10-05" } ], "performanceYear": 2017, "programName": "mips", "taxpayerIdentificationNumber": "000000002"}{ "data ": { "score ": { "name ": "total ", "title ": "Total Score ", "detail ": "0.0.26-hotfix-1 ", "value ": 6, "parts ": [ { "name ": "quality ", "title ": "QUALITY component of final score ", "detail ": "Scoring based on weight of60%. ", "value ": 6, "original ": { "name ": "quality ", "value ": 10, "detail ": "Picked the highest scoring measurement set electronicHealthRecord ", "parts ": [ { "name ": "quality ", "value ": 10, "detail ": "electronicHealthRecord ", "parts ": [ { "name ": "317 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class 2 measure when zero eligiblepopulation ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 1 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS22v5 " } }, { "name ": "128 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class 2 measure when zero eligible population ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 2 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS69v5 " } }, { "name ": "113 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Colorectal Cancer Screening ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class2 measure when zero eligible population ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 3 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS130v5 ", "cpcPlusGroup ": "C " } }, { "name ": "236 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Controlling High Blood Pressure ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class 2 measure when zero eligible population ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 4 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS165v5 ", "cpcPlusGroup ": "A " } }, { "name ": "117 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Diabetes: Eye Exam ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class2 measure when zero eligible population ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 5 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS131v5 ", "cpcPlusGroup ": "C " } }, { "name ": "001 ", "value ": 1, "detail ": "Contributing 1 ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%) ", "endToEndBonus ": 1, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "PICKED ", "totalMeasurementPoints ": 1, "totalBonusPoints ": 1, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class 2 measure when zero eligible population ", "e2eBonusScore ": "Bonus from isEndToEndReported ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Picked at 6 ", "totalMeasurementPoints ": "Measurement points for PICKED measure include decile score with all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS122v5 ", "cpcPlusGroup ": "A " } }, { "name ": "204 ", "value ": 0, "detail ": "Skipped ", "metadata ": { "performanceRate ": 0, "reportingRate ": 0, "measureClass ": "Class 2 ", "measureTitle ": "Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet ", "endToEndBonus ": 0, "outcomeOrPatientExperienceBonus ": 0, "highPriorityBonus ": 0, "decileScore ": 0, "performanceDenominator ": 0, "performanceNumerator ": 0, "eligiblePopulation ": 0, "partialDecileScore ": 0, "partialPoints ": 0, "decile ": -1, "deciles ": null, "processingStatus ": "SKIPPED ", "totalMeasurementPoints ": 0, "totalBonusPoints ": 0, "messages ": { "measurementClass ": "Eligible population is zero ", "decileScore ": "Applied 0 points for Class 2 measure when zero eligible population ", "e2eBonusScore ": "Ignored as we already reached10% cap of denominator ", "outcomeBonus ": "Default outcome bonus ", "highPriorityBonus ": "Default high priority bonus ", "measurementPicker ": "Skipping ", "totalMeasurementPoints ": "Measurement points for SKIPPED measure include all bonus points " }, "noBenchmarks ": false, "benchmarkType ": "electronicHealthRecord ", "eMeasureId ": "CMS164v5 " } } ], "metadata ": { "messages ": { "denominator ": "At least1 high or outcome or patient experience measure available. So denominator is60 ", "bonusScoreCapLimitReached ": "Bonus score has reached the10% cap limit of submission score ", "totalMeasurementPoints ": "Sum of applicable individual measurement points. ", "totalBonusPoints ": "Sum of individual measurement bonus points " }, "maxContribution ": 100, "measuresPicked ": [ "317 ", "128 ", "113 ", "236 ", "117 ", "001 " ], "totalMeasurementPoints ": 6, "totalBonusPoints ": 6, "denominator ": 60, "e2eBonusScore ": 6, "bonusScoreCapLimitReached ": true, "measurementSetPicked ": true, "reweightedScore ": 6 } } ] }, "metadata ": { "maxContribution ": 60 } } ], "metadata ": { "messages ": {}, "maxFinalScore ": 100, "maxHighContributionIA ": 40, "maxMediumContributionIA ": 20, "maxContributionIA ": 15, "maxContributionACI ": 25, "maxContributionQuality ": 60 }, "warnings ": [ "Disclaimer: Scoring is subject to change, based on periodic policy updates, eligibility reviews, and technical integration developments. " ], "errors ": [] } }}Message has been deleted
steven....@semanticbits.com
Dec 8, 2017, 3:37:21 PM12/8/17
to Developer Group for QPP APIs
Thank you! You are correct, the response is not correct, EndToEnd bonus cannot have 0 eligiblePopulation. This work is currently in progress, please let me know if you need any additional information.
bin...@athenahealth.com
Dec 8, 2017, 3:43:42 PM12/8/17
to Developer Group for QPP APIs
So this will be fixed in the live API, and we would expect a zero score to be returned if minimum requirements aren't met?
Steven Szeliga
Dec 8, 2017, 3:45:53 PM12/8/17
to bin...@athenahealth.com, Developer Group for QPP APIs
Yes, that is accurate.
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Thanks,
Steven
bin...@athenahealth.com
Dec 8, 2017, 4:06:26 PM12/8/17
to Developer Group for QPP APIs
Thanks for confirming.
Is there any projected timeline on this?
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