A guide to keeping your points off the ice

January creates the illusion of a clean slate. New dashboards, new priorities, and just enough distance from last year to assume the hard parts are behind you. For EHRs and the practices they support, this is often when MIPS risk quietly starts to build.

MIPS performance is rarely lost in dramatic ways. It slips through small gaps. A measure that looks aligned but is not valid for the selected pathway. A denominator rule that changed. A Promoting Interoperability requirement that was met in practice but not documented correctly. These issues usually surface late, when there is no room left to fix them.

January is when those risks are still manageable.

This is the right time to review measure mapping, MVP alignment across specialties, and whether workflows will actually hold up through the year. Early clarity now can prevent avoidable rework later and keep the reporting season calm instead of reactive.

The Small Errors That Create Big Losses

Missing or incomplete identifiers

CMS requires complete, valid fields for a Quality file to be scored. The most common errors are missing practice IDs, mismatched NPI and TIN combinations, missing measure IDs, or an incorrect CMS EHR Certification ID. These errors are silent. They do not show up until the file is processed.

A quick December audit of all incoming data feeds can prevent an entire category from being rejected.

Tracking measures that will never count

For 2025, CMS restricted several high-use measures to MVPs only. Practices that stayed in Traditional MIPS might’ve continued to track these out of habit. If you rely on measures such as breast cancer screening, Colorectal Cancer Screening, or BMI Screening, recheck once and confirm that your strategy still aligns with traditional MIPS.

Incomplete Promoting Interoperability proof

The PI category still requires a full 180-day reporting period, a signed Security Risk Analysis, a completed SAFER Guide, an accurate certification ID, and the required attestations. Missing one item is enough to void the category.

Many groups do not discover this until they begin the final submission. December is the right time to confirm that every required document exists, is signed, and matches the performance period.

Improvement Activities are not aligned across the group

Large groups often fail here. CMS requires that all clinicians in the group complete the same activities. If some clinicians complete the activity and others do not, the entire group risks losing credit.

A simple year-end verification prevents this disconnect.

Multi-affiliated clinicians are creating unwanted file overwrites

If a clinician works across multiple locations, CMS will score each submission and apply the highest-scoring set. But within the same organization, the most recent submission overwrites previous ones. Many teams discover too late that data they intended to count was replaced.

Coordinating now across locations avoids an unpleasant surprise later.

Why December Matters

By this point in the year, patterns are clear. You can see where data is thin, where measure performance is slipping, and where documentation is incomplete. The advantage is that you still have time to correct course before reporting closes.

A focused December review does three things:

1. It protects your reimbursement.

2. It reduces the time you spend fixing problems during submission.

3. It gives you a calmer submission period with fewer surprises.

How MyMipsScore Keeps Your Score from Melting

MyMipsScore reduces the risk of silent mistakes by validating every file before submission, flagging missing identifiers, warning when measures are invalid, organizing PI evidence, and tracking year-round performance. It acts as a safeguard during the close of the performance year.