Certified Risk Adjustment Coder (CRC)

Which of the following is a quality review measure?

1. APC

2. DRG

3. Uniform Hospital Discharge Data Set (UHDDS)

4. Merit-based Incentive Payment System (MIPS)

The correct answer is: Merit-based Incentive Payment System (MIPS)

The Merit-based Incentive Payment System (MIPS) is recognized as a quality review measure because it is designed to assess the quality of care provided by healthcare professionals and adjust their reimbursement based on their performance. MIPS evaluates various quality measures, including patient outcomes, clinical practice improvement activities, and the use of appropriate technology, thus encouraging providers to deliver higher quality care while practicing efficiently. The significance of MIPS lies in its structured approach to monitoring and enhancing healthcare quality. It combines multiple aspects into a single system, ensuring that clinicians are rewarded not only for the volume of services they provide but also for the quality and effectiveness of those services. This aligns efforts to improve patient care and outcomes while also managing healthcare costs. The other options listed serve different purposes. For instance, APC (Ambulatory Payment Classifications) and DRG (Diagnosis-Related Groups) are primarily focused on payment systems rather than assessing quality. The Uniform Hospital Discharge Data Set (UHDDS) is a data collection tool used for reporting and does not directly evaluate the quality of care. Thus, MIPS stands out as the correct choice for a quality review measure.