PI scores often stall for reasons that don’t become apparent until you take a close look at your CEHRT setup, workflows, and connectivity patterns. When you understand these gaps, you gain the power to fix them long before they threaten your MIPS performance.

Ignoring the MIPS Cost category is risky—it makes up 30% of your score, yet many providers overlook it because scoring happens retroactively. With CMS prioritizing value-based care, optimizing Cost is critical.

Why It Matters:

• High-cost outliers (e.g., avoidable readmissions, excessive post-acute care) hurt performance.

• CMS evaluates your spending against peers—without you submitting data.

• Episode analytics reveal cost drivers, letting you intervene early.

3 Steps to Take Control:

1. Review CMS Feedback – Check your QPP portal to identify high-impact cost measures.

2. Analyze Episode Data – Benchmark costs per condition (e.g., diabetes, joint replacements) and flag outliers.

3. Target Interventions – Optimize care pathways, reduce unnecessary utilization, and improve care coordination.

   The Bottom Line:
   Cost performance isn’t passive—proactive analytics and targeted fixes can boost your score before CMS calculates it.