For the 2021 performance year, eligible clinicians and groups will receive a Cost performance category score that accounts for 20% of their final MIPS score. ECs and groups do not need to submit data or attest to anything for this category. Instead, CMS uses claims data to assess an individual or group's performance during the performance year.
Facility-based measurement scoring will be used for your quality and cost performance category scores when all the following conditions are met: 1.) You're identified as facility-based; and 2.) You're attributed to a facility with a FY 2022 Hospital Value-Based Purchasing (VBP) Program score. The Hospital VBP Program score will be used when it results in a higher combined quality and cost score than the MIPS quality measure data you submit and MIPS cost measure data CMS calculates for you.
In 2021, CMS will use claims data to assess individual ECs and their groups on the following twenty (20) cost measures. Attribution of individual ECs or groups to these measures is often dependent upon the plurality of services and costs provided to individual patients for these measures. If an EC or group is unable to be scored in the Cost category, the 20% weighting will be redistributed to the Quality performance category.
Visit the ASA Cost performance category FAQs for more information.
Population-based cost measures:
Procedural episode-based cost measures:
Acute inpatient medical condition episode-based cost measures:
Cost measure specifications and regulatory information are available on the Quality Payment Program Resource Library website. ASA continues to advocate for physician anesthesiologists to be fairly and accurately assessed under the MIPS cost category.