Questions about MACRA? Ask an AAD expert

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If you have a question about how MACRA will impact you and what you should do to prepare, submit it to the Academy’s MACRA Community, and AAD expert staff will get you an answer. Below is a question and answer from the AAD's MACRA Community.

Q: How is the score for each of the 6 Quality measures determined. Is it simply what percentile of physicians your numbers are better than? For example if I report better than 80% of other physicians for a given measure, does that get me 8 points?

Or is there some more convoluted way that they have come up with?

Or (as I suspect is the case) have they not specified what formula they will use?

Also, do we get a bonus point for reporting on high priority measures?

If so, in the proposed dermatology set, which ones are the High priority measures. In the proposed set, it does not differentiate between Outcome measures and high priority measures.

Lastly, do we also get a bonus point if we report thru Data Derm? If so, is that 1 point added to each measure, or just one point added to our total?

-Submitted by Aaron Katz, MD

A: You can choose to report as a group or as individual physicians regardless of your Tax ID. It may be more beneficial for you to report as a group if all your physicians are using the EHR. Also, only one physician in the group has to complete the practice improvement activity requirements and the full group would receive credit. PAs don't have to perform the advancing care information category, so they would only have to perform the quality score.

Calculating the score for the quality section is actually fairly complex. Each quality measure is worth a possible 10 points, and you can receive a maximum score of 60 points for this section. Thus, you can choose to report 6 quality measures to try to achieve the maximum score of 60 points.

By reporting a measure on one patient, you automatically get 3 points. Each measure then has benchmarks which define how many points you can score based on your performance. For example, Measure 137: Continuity of Care Recall System has the following benchmarks:

Decile 3
Decile 4
Decile 5
 Decile 6  Decile 7  Decile 8  Decile 9
 Decile 10
53.73 -
75.75
75.76 -
88.45
88.46 -
98.07
       --        --        --       --   100

If you report the measure on 60% of your patients, you would be in the 3rd decile. The 3rd decile is equivalent to 3 - 3.9 points, so you would receive a score of 3 - 3.9 points for that measure.

Most of the dermatology-specific measures have a performance score of 100% to achieve decile 10, which is worth the full 10 points. You do receive an additional bonus point for reporting a high priority measure and another additional point for using DataDerm to report quality measures through your EHR. There are 6 high priority measures in the dermatology-specialty set: measures 130, 137, 138, 224, 265, and 374.

We have a full explanation of all the deciles, benchmarks and bonus points at www.aad.org/macra.

-Answer provided by Rachna Chaudhari, AAD Senior Manager, Practice Management Resources

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