Customer Background
A regional pathology group supporting multiple hospital and ambulatory sites needed a single view
of Merit-based Incentive Payment System (MIPS) performance. Historically, Quality, Improvement Activities,
Promoting Interoperability, and Cost results were tracked in separate spreadsheets, registry portals,
and billing reports, making it difficult for leadership to understand incentive readiness or compare
Traditional MIPS with emerging pathology-specific MVP options.
Objective
The objective was to build an executive dashboard that consolidates pathology MIPS performance at the
practice level, supports a full switch between Traditional MIPS and the Pathology MVP, and clearly shows
how readiness in each performance category contributes to the projected MIPS Final Score. The solution
needed to be transparent, auditable, and aligned with College of American Pathologists guidance while
preserving strict de-identification of patient data.
Approach
- Data Integration and Normalization - Combined EHR, LIS, billing, and registry extracts into a curated analytics model keyed to MIPS numerators and denominators, low volume thresholds, and CAP pathology measure specifications.
- Measure Mapping - Mapped pathology quality measures, Improvement Activities, Promoting Interoperability measures, and CMS cost indices to a consistent semantic layer, supporting both Traditional MIPS and the Pathology MVP scoring model.
- AI-enabled Analytics - Implemented an AI agent that scans de-identified data for measure logic anomalies, missing synoptic fields, and scoring edge cases, providing coaching insights directly in the dashboard.
- Executive Dashboards - Delivered the executive view shown above, with KPI cards, six visualizations, and an AI insights panel, all designed to help clinical and operational leaders understand where to invest effort before the submission deadline.
Outcomes
- Consistent, practice-level view of pathology performance across Quality, IA, PI, and Cost in a single dashboard.
- Improved clarity on the tradeoffs between remaining on Traditional MIPS versus moving to the Pathology MVP.
- Reduction in manual MIPS reconciliation work through AI-assisted data validation and measure coaching.
- Increased confidence that projected MIPS Final Scores accurately reflect underlying pathology quality and operational performance.