May 26, 2021
CMS Adjusting Weight for Cost to 0% for 2020 Performance Year
On May 20, 2021, CMS announced that they are reweighting the Cost category from 15% to 0% for the 2020 reporting year. They will redistribute the weight to other categories as shown below. CMS came to this decision based on 3 criteria.
- Decrease in service utilization in 2020 indicating that cost measures might not accurately demonstrate patient risk due to lack of diagnosis information within the lookback period.
- Episodes of COVID-19 diagnoses generally have higher observed and risk-adjusted costs, indicating COVID-19 impacted service utilization and was not sufficiently accounted for through risk adjustment.
- The overall number of clinicians who met 2020 cost measure case minimums substanially decreased from prior performance years. A substantial portion of clinicians had episodes with COVID-19
They will reweight as shown below.
According to CMS, providers do not need to take any action as a result of this decision, since the cost performance category relies on administrative claims data.
You can find more information on this and the QRDA updates by downloading the 2020 MIPS Scoring Guide here.