Eligible Measure Applicability (EMA)
Some subspecialties of medicine may have fewer than six applicable quality measures to choose from. Individual clinicians and groups should then submit data on all applicable measures and include at least one outcome measure if any applicable measures are available. If no outcome measures are applicable, the practice should attempt to identify at least one applicable high-priority measure to submit.
CMS will use the Eligibility Measure Applicability (EMA) process to evaluate whether enough clinically applicable measures have been submitted. If CMS determines that all applicable measures have been submitted they will adjust the scoring accordingly the practice will not be penalized. In other words, CMS will use the scores on the measures submitted to determine the overall score for the quality performance category. For example, if four measures are submitted, CMS will use the scores on these four measures to determine the score for the quality performance category. Each measure would then have a weighting of 12.5 points towards the total MIP score (when the quality performance category waiting is 50 percentage points).
If, however, CMS identifies additional clinically-related measures that they believe should have been included in the measure set that is reported they will essentially credit those measures as having a performance score of zero. For example, if the practice submits four measures and CMS determines that a total of six measures should have been submitted, the four measures will receive a weighting of approximately 8.33 points but the score will be based on performance for six measures. Two of these measures will have a zero performance score making highest possible total for the quality performance category approximately 33.3 out of 50 points.
If the practice submits quality measure data via the claims or qualified registry reporting mechanism, the applicability determination will be specific to the reporting mechanism chosen by the practice. For example if the practice reports measure data via the claims reporting mechanism CMS will limit its applicability search to measures that can the submitted via the claims reporting mechanism. They will not include measures that can be submitted through the registry reporting mechanism and not through the claims reporting mechanism. This is not applicable for the EHR, QCDR and web interface submission mechanisms.