What Do Low-Scoring MIPS Practices Have in Common and How You Can Avoid Their Mistakes

Every year, thousands of healthcare practices receive their MIPS scores and wonder what went wrong. Some barely scrape by, while others face penalties that cut directly into their Medicare reimbursements. The 2025 & 2026 performance threshold sits at 75 points, and practices scoring below that mark will see payment adjustments of up to 9% on their 2027 & 2028 Medicare Part B payments. That’s a significant hit for any practice, especially smaller ones operating on tight margins.

The good news is that low-scoring practices tend to share common patterns. By understanding what these practices get wrong, you can take a different path and position your practice for better outcomes.

Key Takeaways

Low-scoring practices often choose measures that don’t align with their specialty or patient population.
Waiting until year-end to review performance data leads to missed opportunities for improvement.
Data entry errors and incomplete submissions are among the most common reasons for low scores.
Ignoring category weights causes practices to focus on areas with less impact on their final score.
Using the right reporting tools and support can simplify compliance and reduce costly mistakes.

Poor Measure Selection

One of the biggest mistakes low-scoring practices make is choosing measures without considering how well they fit the practice. Some clinicians pick measures based on what seems easy rather than what actually reflects their work. Others select measures that lack benchmarks, which means they can’t earn meaningful points regardless of performance.

Practices that don’t review quality requirements for mips reporting often end up reporting on measures where they score in the lowest deciles. A measure might look straightforward on paper, but if the benchmark is extremely high and/or topped out, your practice can’t realistically hit it, you’re setting yourself up for disappointment.

Smart practices analyze their past performance data before selecting measures. They look at which measures align with their patient mix and clinical workflows, and they check benchmark data to see where they can realistically score well.

doctor analyzing data on computer

Related: What is MIPS in Healthcare

Reactive Rather Than Proactive Tracking

Low-scoring practices often treat MIPS as an end-of-year task. They collect data throughout the year but don’t look at it until submission deadlines approach. By then, it’s too late to fix problems or adjust their approach.

Practices that excel at MIPS review their performance data regularly; at a minimum once per quarter. This gives them time to spot trends, address gaps, and make adjustments before the reporting period ends. Implementing strategies to optimize mips performance throughout the year makes a real difference because real-time analytics help you see where you stand at any given moment.

Data Entry and Submission Errors

Even practices with strong clinical performance can end up with low scores if their data is inaccurate or incomplete. Manual data entry is prone to mistakes, and those mistakes add up quickly. A missing field here, an incorrect code there, and suddenly your submission doesn’t reflect the care you actually provided.

For 2025, you need to select a numerator performance quality action on at least 75% of all 100% of your eligible encounters for your quality measures. Falling short of that data completeness threshold means your measure won’t count, regardless of how well you performed.

Here’s what high-performing practices do differently:

They use automated validation tools to catch errors before submission.
They assign clear responsibilities so someone is accountable for reviewing data accuracy.
They submit early enough to allow time for corrections if something goes wrong.

Related: Preparing for MIPS submissions

Misunderstanding Category Weights

MIPS scores come from four performance categories, and each one carries a different weight:

Quality: 30%
Cost: 30%
Promoting Interoperability: 25%
Improvement Activities: 15%

Low-scoring practices sometimes pour effort into categories that carry less weight while neglecting the ones that matter most. A practice might complete more Improvement Activities than required while struggling in Quality. That’s a problem because Quality has twice the weight of Improvement Activities.

If you haven’t verified your mips eligibility status, that’s a good place to start. You can also explore mips measures and activities to find options that work best for your situation.

nurse smiling while looking at a doctor

Ignoring Available Resources

Many low-scoring practices try to handle MIPS on their own without the right tools or expertise. They rely on spreadsheets instead of integrated reporting platforms. They guess at requirements instead of consulting the latest CMS guidelines.

Professional mips reporting services provide guidance on measure selection, data validation, and submission timelines. For practices with specialty-specific needs, qcdr reporting solutions offer access to measures you won’t find elsewhere. The difference between a practice that struggles and one that succeeds often comes down to having the right support system in place.

Not Learning From Past Performance

CMS provides performance feedback after each performance year, but many practices never review the feedback in the QPP portal. This information shows exactly where you lost points and why, your total score, your score in each category, AND your final payment adjustment percentage. They highlight measures that underperformed, categories where you fell short, and specific areas for improvement.

Practices that improve year over year treat these reports as roadmaps. They identify what went wrong, adjust their approach, and track whether those changes make a difference. Without this feedback loop, you’re likely to repeat the same mistakes.

Take Control of Your MIPS Performance

Avoiding these common pitfalls doesn’t require a complete overhaul of your practice. It starts with understanding the rules, selecting the right measures, and tracking your progress throughout the year. If you’re ready to see how a qualified registry can help you improve your scores and reduce administrative burden, schedule a demo with Patient360 to learn more.

Conclusion

Low MIPS scores rarely happen by accident. They’re usually the result of poor measure selection, reactive tracking, data errors, or misallocated effort. By learning from the mistakes of others, you can build a reporting strategy that protects your reimbursements and reflects the quality of care you provide.