Closing the Referral Loop: Receipt of Specialist Report
Description: The percentage of patients with referrals during the reporting period whose referring physician received a report back from the other physician.
Measure ID: 374
CMS Derm Specialty Set: Yes
High priority: Yes
Topped out: No
Reporting methods: Registry/QCDR, or EHR
Maximum points: 10
Measure purpose: This measure encourages coordination of care and communication between the referring physician and the physician who receives the referral. Such communication can reduce costs and improve patient outcomes.
The numerator: The number of patients with referrals during the reporting period whose referring physician received a report back from the other physician
The denominator: The number of patients who were referred by one provider to another provider during the reporting period.
Measure calculation example
Dr. Sitarides referred 68 patients to another physician during the reporting period. This is the denominator.
For 19 of these 68 referrals, Dr. Sitarides received a report back from the other physician. This is the numerator.
Quality of patient care = 19/68. Dr. Sitarides has a score of 27.9% for this measure. This translates to 4.0 to 4.9 points when reporting by registry.
Because of how this measure is structured, physicians score 3 points even if they report on only one patient encounter. Physicians must achieve a performance score higher than 99.02% to achieve the full 10 points available.
Quality measure score benchmark
CMS will award points based on a comparison of your performance rate to CMS benchmarks listed below. Reach the performance rate listed to achieve the corresponding points per measure. Points achieved for the Quality category will account for 45% of the overall MIPS score.
Benchmarks for registry submissions/QCDR submission
The table below shows CMS benchmarks for registry submissions.
|Below 3||Decile 3||Decile 4||Decile 5||Decile 6||Decile 7||Decile 8||Decile 9||Decile 10|
|Performance rate||1 patient||6.77 -
|Points||3||3 - 3.9||4 - 4.9||5 - 5.9||6 - 6.9||7 - 7.9||8 - 8.9||9 - 9.9||10|
Benchmarks for EHR submissions
The table below shows CMS benchmarks for EHR submissions.
|Below 3||Decile 3||Decile 4||Decile 5||Decile 6||Decile 7||Decile 8||Decile 9|
|Performance rate||1 patient||7.63 -
|Points||3 points||3 - 3.9||4 - 4.9||5 - 5.9||6 - 6.9||7 - 7.9||8 - 8.9||9 - 9.9||10|