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CMS 2016 Prior Year Benchmarks in the 2016 Quality and Resource Use Reports

Thu, April 13, 2017 4:42 PM | Trey Carver (Administrator)

This document provides the quality benchmarks and standard deviations for each quality measure that may be included in the Performance Year 2016 Quality and Resource Use Reports and used in the calculation of the 2018 Value Modifier. There are four types of quality benchmarks that may be used to calculate a TIN’s Quality Composite Score for the 2018 Value Modifier: 

  1. CMS-Calculated Outcome measures (Table 1) 
  2. Physician Quality Reporting System (PQRS) measures (Table 2) 
  3. Electronic Clinical Quality measures (eCQM) reported to the PQRS (Table 3) 
  4. Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures (Table 4) 

Starting with the 2018 Value Modifier, separate benchmarks will be used for eCQM and non-eCQM PQRS measures. The benchmarks for each quality measure are based on the performance of all solo practitioners and groups nationwide in 2015, the year prior to the performance period. The benchmarking and measure calculation methodology is described at the end of this document. 

Download full document from CMS here: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/Downloads/PY2016-Prior-Year-Benchmarks.pdf

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