MIPS Improvement Activities · QIOs work under the direction of CMS to assist MIPS eligible...
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MIPS Improvement Activities Alexandra Page, M.D. Chair, AAOS Health Care Systems Committee Getting to 40 points: How do I Choose?
Transcript of MIPS Improvement Activities · QIOs work under the direction of CMS to assist MIPS eligible...
MIPS
Improvement Activities
Alexandra Page, M.D.
Chair, AAOS Health Care Systems Committee
Getting to 40 points:
How do I Choose?
DISCLOSURES
My disclosures are listed on the
AAOS Website.
I have no conflicts relevant to this presentation
Improvement Activities
Why?
Quality Payment Program
“. . . care focused on care coordination,
beneficiary engagement, and patient safety.”
“. . .incentives that help drive participation
in certified patient-centered medical homes
and APMs”
ACI 25
Improvement 15Quality 60
Cost 0
2017
ACI Improvement Quality Cost
ACI 25
Improvement 15Quality 45
Cost 15
2018
ACI Improvement Quality Cost
ACI 25
Improvement 15
Quality 30
Cost 30
2019
ACI Improvement Quality Cost
Instructions from CMS (for
2017)1. Review and select activities that best fit
your practice.
2. Download a CSV file of the activities
you have selected for your records.
3. Attest that you completed activities
totaling 40 points for a minimum of 90
days.
Different Improvement Groups:
Need 40 points
• High value = 20 points
• Medium value = 10 points
> 15 clinicians
</= 15 clinicians or rural/HPSA
APM participants
Different Improvement Groups:
Need 40 points
> 15 clinicians
• High value = 40 points
• Medium value = 20 points
</= 15 clinicians or rural/ HPSA
APM participants
Different Improvement Groups:
Need 40 points
> 15 clinicians
</= 15 clinicians or rural/HPSA
• PCMH – completed!
• Non-MIPS APM – half total points
• MIPS APM – based on participation
APM participants
MIPS APM
2017 scoring
standard
The Shared Savings Program and the Next
Generation ACO Model: 20%
Other MIPS APMs (CPC+ Model, the CEC
Model, and the OCM) : 25%
[Recall: Improvement 15% for regular MIPS]
Improvement Activities: Examples
ACTIVITY NAMEACTIVITY
WEIGHTING
Use of patient safety tools
Consultation of Physician Drug Monitoring Program (PDMP)
Medium
High
Use of QCDR data for ongoing practice assessment and improvements Medium
Leveraging a QCDR for use of standard questionnaires Medium
Implementation of use of specialist reports back to referring clinician or group to close referral loop Medium
Implementation of fall screening and assessment programs Medium
Engage patients and families to guide improvement in the system of care. Medium
Engagement of new Medicaid patients and follow-up High
Collection and use of patient experience and satisfaction data on access Medium
Care transition documentation practice improvements Medium
Annual registration in the Prescription Drug Monitoring Program Medium
Care coordination agreements that promote improvements in patient tracking across settings Medium
https://qpp.cms.gov/measures/ia
ACTIVITY NAME ACTIVITY DESCRIPTION ACTIVITY ID SUBCATEGORY WEIGHT
Consultation of the
Prescription Drug
Monitoring program
Clinicians would attest that, 60 percent for first year, or
75 percent for the second year, of consultation of
prescription drug monitoring program prior to the
issuance of a Controlled Substance Schedule II (CSII)
opioid prescription that lasts for longer than 3 days.
IA_PSPA_6
Patient Safety
& Practice
Assessment
High
Engagement of
community for health
status improvement
Take steps to improve health status of communities, such
as collaborating with key partners and stakeholders to
implement evidenced-based practices to improve a
specific chronic condition. Refer to the local Quality
Improvement Organization (QIO) for additional steps to
take for improving health status of communities as there
are many steps to select from for satisfying this activity.
QIOs work under the direction of CMS to assist MIPS
eligible clinicians and groups with quality improvement,
and review quality concerns for the protection of
beneficiaries and the Medicare Trust Fund.
IA_PM_5Population
ManagementMedium
Engagement of new
Medicaid patients and
follow-up
Seeing new and follow-up Medicaid patients in a timely
manner, including individuals dually eligible for Medicaid
and Medicare.
IA_AHE_1Achieving
Health EquityHigh
Engagement of patients,
family and caregivers in
developing a plan of care
Engage patients, family and caregivers in developing a
plan of care and prioritizing their goals for action,
documented in the certified EHR technology.
IA_BE_15Beneficiary
EngagementMedium
Reporting on Improvement Activity
Reporting on Improvement Activity
Attestation
Qualified Registry
Qualified Registry
with CEHRT
Qualified Clinical
Data Registry
(QCDR)
CMS Web Interface
(25+ group size)
Reporting on Improvement Activity
What’s a “Qualified Registry?”
https://qpp.cms.gov/docs/QPP_M
IPS_2017_Qualified_Registries.p
df
. . and Improvement Activities can be
improved!
Relevance to existing programs
Importance in achieving improved health outcomes
Importance in reducing health care disparities
Alignment with PCMH
Representative of activities multiple ECs can perform
Ease of implementation, minimizing reporting burden
CMS can validate the activity
Evidence supporting that an activity has a high
probability of improving health outcomes
CMS is also considering expanding the number of subcategories to give providers even more options. Whether CMS will approve a new subcategory depends on:
• The designated number of activities that meet the criteria for an improvement activity and cannot be classified
under existing categories
• Whether newly identified subcategories would contribute to improvement in patient care practices or
improvement in quality measures/cost categories
• Whether it would highlight improved health outcomes, patient engagement and safety based on evidence
The reduction in required CPIA activities gives practices more time to adjust to this scoring
In an APM?
◦ Participants in certified patient-centered medical homes, comparable specialty practices, or an APM designated as a Medical Home Model:You will automatically earn full credit.
◦ Participants in certain APMs automatically be scored based on the requirements of participating in the APM.
◦ Participants in any other APM: You will automatically earn half credit and may report additional activities to increase your score.
