Solutions for Quality Directors

9% Bonus or 9% Penalty.
Know Which Side You're On.

MIPS final scores determine a meaningful adjustment on every Medicare Part B dollar. Vizier tracks your quality measures, Improvement Activities, and Promoting Interoperability metrics in real time — so you never submit a score that surprises you.

See a Live Demo →MIPS Reporting Solutions
75+MIPS final score needed to avoid penalty under 2025 thresholds
MIPS Quality Measures

Measure-Level Tracking Against Benchmark Performance Rates

The MIPS Quality category is worth 30% of your final score. Vizier tracks every submitted measure against CMS benchmark data, projects your point total in real time, and flags measures where you are at risk of falling below the 30th percentile — the threshold below which points are not awarded.

NQF 0059
Diabetes: HbA1c Poor Control (>9%)
Benchmark: < 23.8% of diabetic patients
QualityUp to 10 pts
NQF 0089
Preventive Care: Influenza Immunization
Benchmark: > 72.1% of eligible patients
QualityUp to 10 pts
NQF 0421
Adult BMI Assessment
Benchmark: > 98.6% of adult patients
QualityUp to 10 pts
NQF 0028
Preventive Care: Tobacco Use Cessation
Benchmark: > 71.8% screened and counseled
QualityUp to 10 pts
NQF 0034
Colorectal Cancer Screening
Benchmark: > 74.2% of eligible patients 45–75
QualityUp to 10 pts
NQF 0052
Use of Imaging for Low Back Pain
Benchmark: < 36.1% imaging rate
QualityUp to 10 pts
HRRP Readmission Tracking

HRRP Measures Tracked Before CMS Calculates Penalties

The Hospital Readmissions Reduction Program measures excess readmission ratios for six conditions: acute myocardial infarction (AMI), heart failure (HF), pneumonia, COPD, total hip/knee arthroplasty (THA/TKA), and coronary artery bypass graft (CABG). Hospitals in the highest penalty tier face up to 3% Medicare payment reduction.

Vizier tracks 30-day readmissions by condition, computes your excess readmission ratio against national cohort data, and projects penalty exposure for each program year. Discharge planning gaps — missing follow-up appointments, unfilled prescriptions, social determinant flags — are surfaced at the individual patient level before discharge.

AMI 30-day readmission national average15.9%
HF 30-day readmission national average21.9%
Pneumonia 30-day readmission national average16.7%
Average HRRP penalty per hospital$217K
Infection Rate Monitoring

CAUTI, CLABSI, and SSI Tracking for Joint Commission Readiness

Healthcare-associated infections (HAIs) are tracked through standardized infection ratios (SIR) benchmarked against the CDC National Healthcare Safety Network (NHSN). CAUTI, CLABSI, MRSA bacteremia, C. difficile, and SSI rates are monitored in real time with control chart visualization.

Joint Commission survey preparation is continuous, not episodic. Vizier maintains a live survey-readiness dashboard against the Comprehensive Accreditation Manual for Hospitals (CAMH) standards — flagging documentation gaps, policy expiration dates, and performance measure variances before a surveyor walks through the door.

CAUTI SIR national benchmark (target)< 1.0
CLABSI SIR national benchmark (target)< 1.0
SSI SIR — colon surgery national average1.03
CMS HAC Reduction Program penalty1% Medicare
HEDIS & CMS Star Ratings

CMS Star Rating Optimization and HEDIS Performance Tracking

CMS Medicare Advantage star ratings determine plan bonus payments — a 5-star plan receives a 5% quality bonus on benchmark payments. Moving from 3 stars to 4 stars unlocks quality bonus payments that can exceed $500 per member per year. The star rating calculation covers five categories: Staying Healthy screenings (25%), Managing Chronic Conditions (25%), Member Experience (20%), Member Complaints (20%), and Health Plan Administration (10%).

HEDIS measure performance across 40+ measures is visible at the individual patient, provider, and population level. Vizier maps care gaps directly to HEDIS denominators — identifying which patients need breast cancer screening (BCS), cervical cancer screening (CCS), comprehensive diabetes care (CDC), or blood pressure control (CBP) to move the measure rate.

Promoting Interoperability Metrics

The Promoting Interoperability (PI) performance category accounts for 25% of the MIPS final score. Vizier tracks all required PI measures automatically from your EHR data: e-prescribing rates, health information exchange (HIE) usage, patient access through APIs, public health registry reporting, and clinical data registry submissions.

e-Prescribing
Must report; 10% base score
Target: >80% of Rx
Query of PDMP
Required for controlled substances
Target: 100% compliance
Support Electronic Referral Loops
Required measure
Target: >80% electronic
Provide Patients Electronic Access
Required measure
Target: >80% of patients
9%
Maximum MIPS bonus on all Medicare Part B payments
9%
Maximum MIPS penalty for low performers — same stakes, opposite direction
75+
MIPS final score required to avoid any penalty in 2025
40+
HEDIS measures tracked across commercial, Medicare, and Medicaid lines
Related Solutions

Quality Extends Across Every Role

Know Your Score Before CMS Does

Real-Time MIPS Tracking, Not Year-End Surprises

Upload your EHR data export and see your projected MIPS final score, measure-level performance against benchmarks, and penalty risk — in under 48 hours.