MIPS #374 Closing the Referral Loop

2025: no measure changes from 2024

MEASURE DESCRIPTION

Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred

Relevance to Value Based Care

Information exchange between providers, for time-limited referrals or consultations, on-going co-management, or during care transitions facilitates the coordination of care. 

Care coordination improves quality of care for patients, reduces hospitalizations, and improves adherence to evidence-based care guidelines.

The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure.

 Numerator

Number of patients with an outgoing referral on or before October 31, for which the referring clinician received a report back from the clinician to whom the patient was referred

Denominator

Number of patients, regardless of age, who had an encounter during the measurement period & referred by one clinician to another clinician on or before October 31st

Exclusion/Exceptions

None.

 Scoring

Up to 10 points

 RESOURCES

2024 CMS eCQM Specifications for Closing the Referral Loop

2025 CMS eCQM Specifications for Closing the Referral Loop Link