Half of all clinicians score below the median on Cost. Most never learn why.

Unlike Quality, where you choose the measures, CMS chooses your Cost measures from your claims. The same methodology that calculates your MIPS Cost score today will determine your performance in mandatory models like ASM starting January 2027.

Cost Weight Over Time
0%
Cost weight (2019)
15%
Cost weight (2022)
30%
Cost weight (2026)
50%
Cost weight under ASM (2027)

Why This Matters Now

Your MIPS final score is calculated from four categories, each with a different weight. For years, Cost was weighted low enough to ignore. Now it's tied with Quality at 30%, making them the two heaviest categories in the program. A weak Cost score can single-handedly drag a final score below the 75-point threshold where the MIPS penalty begins.

CMS calculates the Cost category entirely from claims data it already has. You never submit a thing.

And when ASM launches in 2027, Cost alone will determine half your score. The practices that understand their episode costs today will have a two-year head start.

The Strategic Reality

Yesterday's data is your roadmap for today.

The MIPS Cost category often feels like a lagging indicator because it relies on retrospective QPP data. However, for most specialty practices, the patients driving your costs last year are the same patients in your exam rooms today.

Policy to Practice

CMS assigns the costs. We show you whose they are.

CMS uses complex rules to attribute patients and costs to your practice. We translate that methodology into names, dates, and dollar amounts you can act on.

Waiting for the CMS final report 6+ months after the year ends
Year-round monitoring of claims data to intervene in real time
Guessing which patients are attributed to the practice
Clear attribution logic that identifies exactly who is driving your costs
Viewing cost as an uncontrollable administrative burden
Using cost data as a strategic lever to prepare for mandatory ASM models
Reacting to poor performance after the fact
Proactive care coordination strategies that address root causes

Episode Visibility

Anatomy of a high-cost episode.

A single clinical event can trigger an episode that spans months and accumulates costs across multiple providers. Here is what practices typically miss, and what VBCA surfaces.

Episode Journey
From the VBCA Programs Portal · illustrative episode
Pre-Admit
(3 days)
Index Admission
Avg 5.2 days
Post-Discharge (30 days)
Home (no services)38%
Home Health26%
SNF10%
Rehab/LTCH5%
Readmitted21%

CMS attributes the full window to your practice: every dollar, including care you never saw. In this episode, one number decides the score: the 21% readmitted. That is the line our care-intervention work targets.

What most practices see:

A score on an annual feedback report, months after the performance year ends. No visibility into which patients drove the costs or what could have been done differently.

What VBCA surfaces:

Patient-level episode costs as they accumulate, the service categories running above benchmark, and where the “leaks” are occurring, early enough to intervene.

Our Take

Cost performance is a combination of longitudinal patient management and acute surgical outcomes. We help you identify the specific “outlier” events and recurring patterns in your data so you can intervene before the next episode begins.

The Portal View

Every cost measure, positioned against its benchmark.

This is the view our clients work from: each attributed cost measure, your percentile position, the national benchmark, and your actual cost. The conversation moves from “our score is low” to “heart failure episodes are running 40% over, and here are the patients.”

Cost Performance by Measure
From the VBCA Programs Portal · illustrative practice
0%25%50%75%100%
Decile
Benchmark
Your Cost
Heart Failure
4.7
$14,165
$19,822 +40%
Asthma/COPD
5.5
$4,927
$6,396 +30%
Diabetes
6.9
$7,562
$8,224 +12%
MSPB Clinician
7.8
$23,585
$23,728 +1%
Total Per Capita Cost
8.0
$1,540
$1,364 −11%

Higher percentile = better performance · Benchmark shown in gray, your cost in bold

Next Steps

Three steps to a better Cost score.

1 · Baseline

Establish your current episode-based cost measures: which episodes you're being scored on, and where you stand relative to benchmark.

2 · Benchmark

Compare your performance against specialty-specific peers. Identify which service categories and patient cohorts are driving variance.

3 · Optimize

Implement care coordination strategies that address root causes before the costs hit your score, and before ASM makes cost performance mandatory.

Ask us which episodes CMS scored you on.

We'll walk through your attributed cost measures and where each one sits against benchmark. The same data drives ASM performance in 2027, so knowing your position now gives you time to act.