Under MACRA, which MIPS category is focused specifically on reducing the overall cost of care?

• A. Cost
• B. Quality
• C. Improvement Activities
• D. Promoting Interoperability

Answer: (B)

In MACRA’s MIPS framework, there are four performance pillars, each addressing a different aspect of care. The pillar focused on reducing the overall cost of care is the Cost category. It evaluates the actual spending associated with a patient’s care, using measures like Medicare Spending Per Beneficiary and episode-based cost metrics. The goal is to incentivize clinicians to be more efficient and to curb unnecessary spending across the care continuum, rather than only reporting what happened or how well processes were followed.

In contrast, the Quality pillar assesses how well care aligns with outcomes and evidence-based practices, the Improvement Activities pillar rewards efforts to improve care processes and patient safety, and the Promoting Interoperability pillar encourages the use of certified EHRs and the exchange of health information. Each category targets a different dimension of value, but the one specifically tied to cost containment is the Cost category.