jondoe
Dec 26, 2018, 8:08:44 AM12/26/18
to Developer Group for QPP APIs
Hello,
Please, let us guide about scoring against CMS138 measure has skipped to benchmark and set it to docile points 3 and shows class2
Please help what is logic behind class 2
measures and how it is identified?
measures and how it is identified?
I have attached request.json and response.json
request.json
request.json
{
"submission": {
"programName": "mips",
"entityType": "individual",
"taxpayerIdentificationNumber": "REDACTED",
"nationalProviderIdentifier": "REDACTED",
"performanceYear": 2018
},
"category": "quality",
"submissionMethod": "electronicHealthRecord",
"performanceStart": "2018-01-01",
"performanceEnd": "2018-12-24",
"measurements": [
{
"measureId": "226",
"value": {
"isEndToEndReported": true,
"strata": [
{
"performanceMet": 13,
"eligiblePopulationExclusion": 0,
"eligiblePopulationException": 0,
"performanceNotMet": 10,
"eligiblePopulation": 23,
"stratum": "screenedForUse"
},
{
"performanceMet": 21,
"eligiblePopulationExclusion": 0,
"eligiblePopulationException": 0,
"performanceNotMet": 4,
"eligiblePopulation": 25,
"stratum": "overall"
},
{
"performanceMet": 20,
"eligiblePopulationExclusion": 0,
"eligiblePopulationException": 0,
"performanceNotMet": 1,
"eligiblePopulation": 21,
"stratum": "tobacco"
}
]
}
}
]
}
response.json
{
"data": {
"score": {
"name": "total",
"title": "Total Score",
"detail": "0.55.2",
"value": 3.33,
"parts": [
{
"name": "ia",
"title": "IA component of total score",
"detail": "Scoring based on weight of 15%.",
"value": 0,
"original": {
"name": "ia",
"value": 0,
"detail": "Picked the highest scoring measurement set electronicHealthRecord",
"parts": [
{
"name": "ia",
"value": 0,
"title": "Improvement Activities Score",
"detail": "electronicHealthRecord",
"parts": [],
"metadata": {
"messages": {},
"maxContribution": 40,
"measurementSetId": "03a1ccdd-8a63-4474-ab59-a2878695716f",
"measurementSetPicked": true
}
}
],
"instrumentations": []
},
"metadata": {
"unroundedScoreValue": 0,
"maxContribution": 15
}
},
{
"name": "pi",
"title": "PI component of total score",
"detail": "No measurement set to score.",
"value": 0,
"original": {
"instrumentations": [
{
"reasonCode": "PI-006",
"message": "A minimum of 90 days is required for PI. A time period of less than 90 days will result in a score of 0 for year 2."
}
]
}
},
{
"name": "quality",
"title": "QUALITY component of total score",
"detail": "Scoring based on weight of 50%.",
"value": 3.33,
"original": {
"name": "quality",
"value": 6.7,
"detail": "Picked the highest scoring measurement set electronicHealthRecord",
"parts": [
{
"name": "quality",
"value": 6.7,
"detail": "electronicHealthRecord",
"parts": [
{
"name": "226",
"value": 4,
"detail": "Contributing 4",
"instrumentations": [
{
"reasonCode": "QUALITY-009",
"message": "Measurement meets the minimum reporting rate for this attestation year."
},
{
"reasonCode": "QUALITY-052",
"message": "Measure is a class 2 measure because eligible population is >= 20 and reporting rate > 60 but has no benchmarks"
},
{
"reasonCode": "QUALITY-086",
"message": "For year 2018, apply maximum points for Class 2 measure meeting data completeness."
},
{
"reasonCode": "QUALITY-096",
"message": "If measure is end to end reported, then end to end bonus score is applied."
},
{
"reasonCode": "QUALITY-111",
"message": "Measure contributed points to total score."
},
{
"reasonCode": "QUALITY-113",
"message": "Measure contributed bonus points to total score."
},
{
"reasonCode": "QUALITY-117",
"message": "Measurement points for PICKED measure include decile score with all bonus points."
}
],
"metadata": {
"performanceRate": 84,
"reportingRate": 100,
"measurementSetId": "03a1cce1-8db8-48c1-ab27-1d9e038a816d",
"measurementId": "03a215dd-39b7-4eea-8c68-6e2040ac7672",
"measureClass": "Class 2",
"measureTitle": "Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention",
"endToEndBonusEligible": true,
"endToEndBonus": 1,
"outcomeOrPatientExperienceBonus": 0,
"highPriorityBonus": 0,
"decileScore": 3,
"performanceDenominator": 25,
"performanceNumerator": 21,
"eligiblePopulation": 25,
"partialDecileScore": 0,
"partialPoints": 0,
"decile": -1,
"deciles": null,
"processingStatus": "PICKED",
"totalMeasurementPoints": 4,
"totalBonusPoints": 1,
"messages": {
"measurementClass": "Eligible population is greater than or equal to 20, reporting rate is greater than 60% but has no benchmarks",
"decileScore": "Applied maximum points for Class 2 measure meeting data completeness",
"e2eBonusScore": "Bonus from isEndToEndReported",
"measurementPicker": "Picked at 1",
"totalMeasurementPoints": "Measurement points for PICKED measure include decile score with all bonus points"
},
"noBenchmarks": true,
"benchmarkType": null,
"eMeasureId": "CMS138v6",
"cpcPlusGroup": "Other_Measure",
"toppedOut": null,
"isGhost": false,
"unroundedScoreValue": 4
}
}
],
"instrumentations": [
{
"reasonCode": "QUALITY-072",
"message": "No high or outcome exists. Denominator is 60, but only top 5 scoring measures are considered."
},
{
"reasonCode": "QUALITY-099",
"message": "Measurement set does not have high priority measure."
},
{
"reasonCode": "QUALITY-116",
"message": "Applicable measurement points summed."
}
],
"metadata": {
"messages": {
"denominator": "No high or outcome exists. Denominator is 60, but only top 5 scoring measures are considered",
"hasHighPriorityMeasurements": "Measurement set does not have high priority measure",
"totalDecileScore": "Decile score points for measurements included in measurement set score, excluding bonus points",
"totalBonusPoints": "Sum of measurement bonus points included in the measurement set score",
"totalMeasurementPoints": "Sum of applicable measurement points."
},
"measurementSetId": "03a1cce1-8db8-48c1-ab27-1d9e038a816d",
"maxContribution": 100,
"hasHighPriorityMeasurements": false,
"measuresPicked": [
"226"
],
"totalDecileScore": 3,
"totalBonusPoints": 1,
"totalMeasurementPoints": 4,
"denominator": 60,
"e2eBonusScore": 1,
"maxMeasurementsAllowed": 5,
"mergedWithCahps": false,
"processingStatus": "PICKED",
"unroundedScoreValue": 4,
"measurementSetPicked": true,
"reweightedScore": 4
}
}
],
"metadata": {
"unroundedScoreValue": 6.666666666666667
},
"instrumentations": [
{
"reasonCode": "QUALITY-072",
"message": "No high or outcome exists. Denominator is 60, but only top 5 scoring measures are considered."
},
{
"reasonCode": "QUALITY-099",
"message": "Measurement set does not have high priority measure."
},
{
"reasonCode": "QUALITY-116",
"message": "Applicable measurement points summed."
}
]
},
"metadata": {
"maxContribution": 50,
"unroundedScoreValue": 3.3333333333333335
}
},
{
"name": "feedback-quality",
"parts": [
{
"name": "226",
"detail": "Focus on improving measure 226"
}
]
}
],
"instrumentations": [
{
"reasonCode": "PI-006",
"message": "A minimum of 90 days is required for PI. A time period of less than 90 days will result in a score of 0 for year 2."
}
],
"metadata": {
"messages": {},
"maxTotalScore": 100,
"maxHighContributionIA": 20,
"maxMediumContributionIA": 10,
"maxContributionIA": 15,
"maxContributionQuality": 50,
"maxContributionCost": 10,
"maxContributionPI": 25,
"isSubmissionFabricated": false,
"hasIAMeasures": false,
"hasQualityMeasures": true,
"hasACIMeasures": false,
"hasPIMeasures": false,
"hasCostMeasures": false,
"hasACRMeasure": false,
"hasCAHPSMeasure": false,
"hasScorableIAMeasures": false,
"hasScorableACIMeasures": false,
"hasScorablePIMeasures": false,
"hasScorableCostMeasures": false,
"hasScorableQualityMeasures": true,
"hasSkippedWIMSet": false,
"hasMergedRegistryMSet": false,
"givenIAStudyCredit": false,
"hasIAWeightStatus": "NORMAL",
"givenAPMParticipationCredit": false,
"givenIACreditPCMH": false,
"hasMinimumACIPerformancePeriod": false,
"hasMinimumPIPerformancePeriod": false,
"hasIncompleteAPMWISubmission": false,
"unroundedScoreValue": 3.3333333333333335
},
"warnings": [
"Disclaimer: Scoring is subject to change, based on periodic policy updates, eligibility reviews, and technical integration developments.",
"Invalid PI category measurement set(s)"
],
"errors": []
}
}
}
T
Sarah White
Jan 2, 2019, 10:58:18 AM1/2/19
to jondoe, Developer Group for QPP APIs
Hi,
Measure 226's historical benchmark was removed recently by CMS as the measure had changed significantly enough to warrant the historic benchmark for most instances (all except WI) not applicable. This measure will be scored against a PY benchmark after the submission window is closed.
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