​​MACRA University

Resource Use

This is also referred to as the Cost Category.  No separate reporting is required, but Medicare will use claims data to measure the cost of care provided to patients that are attributed to clinicians and groups of clinicians.  This program is essentially already in place through the Value-base Modifier program, which it will replace.

Resource use will be not be used for MIPS Composite Performance Score determination in 2017. Starting in the 2018 performance year, Medicare will use 40 episode specific measures to account for differences in the cost of care, in particular amongst specialists.

Clinicians with the lowest expenditure rates will have the highest scores in this category. 

Medicare will not use this category if the clinician see fewer than 20 patient in a year that match one of the 40 episode specific measures.  In that case, Medicare will increase the relative weighting of the other MIPS performance categories to account for “missing” 10 points.

Medicare will determine the resource use score based on the average score of all cost measures that can be attributed to that clinician.