Resource Use (Cost) is essentially replacing the Value-Based Modifier and only counts for 10 percent of your overall MIPS score in year one, but don’t let that small number fool you. CMS is proposing that the Cost/Resource Use category account for 15 percent in 2020 and 30 percent of your total MIPS score in 2021 and beyond. The good thing about this performance category is that it requires no reporting from you. CMS gathers the data from Medicare claims, so there’s no administrative burden on your practice, and they calculate measures based on the claims and availability of sufficient volume. The Resource Use performance category generally requires a 20-patient sample and is calculated based on the average score of all attributed cost measures.
This category is arguably one of the most complicated pieces in the MIPS puzzle and may be the most difficult to impact, in terms of improving your score. To ensure your practice’s success, focus on the performance categories you can impact, like Advancing Care Information (rough translation: Meaningful Use), Quality and Clinical Practice Improvement Activities (new), and invest in software that will gauge your performance in all four MIPS categories at all times, so that you’re constantly aware of how you’re doing.