A recent study published in Health Affairs Scholar is raising concerns about how the Centers for Medicare & Medicaid Services (CMS) evaluates quality performance under the Merit-based Incentive Payment System (MIPS). Between 2017 and 2023, nearly half of MIPS quality measures were labeled as “topped out”—a designation typically used when performance is consistently high and improvement opportunities are considered limited.
However, the study found that many of these measures were reported by only a small percentage of eligible clinicians, with a median reporting rate of just 7.1%. This suggests that the “topped-out” classification may not fully reflect broad provider performance.
If measures are deemed topped out too early, it could reduce opportunities for continued quality improvement and limit meaningful participation options within MIPS.
Resource: MIPS topped-out measures have low physician reporting rates