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Measure 374


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

Type: Process

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.  

Calculation

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.

Important note

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.


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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 3Decile 3
Decile 4Decile 5
Decile 6Decile 7Decile 8Decile 9Decile 10
Performance rate  1 patient 6.77 - 
8.50
8.51 - 
37.83
37.84 - 
62.85
62.86 - 
82.42
82.43 - 
88.88
88.89 - 
92.73
92.74 - 
99.01
99.02
Points  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 3Decile 4Decile 5Decile 6Decile 7Decile 8Decile 9
Performance rate  1 patient  7.63 - 
14.97
 14.98- 
26.32
26.33 - 
36.73
36.74 - 
48.14
48.15 - 
60.24
 60.25- 
74.43
74.44 - 
90.74
>= 
90.75 
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

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