The Improvement Activities Performance Category of MIPS is the the newest quality improvement initiative from CMS. Reporting this category is relatively simple, entailing only that eligible clinicians or groups attest to completing between one and four out of 92 pre-selected improvement activities. Selecting Improvement Activities and understanding how the impact your MIPS final score can be tricky.  Luckily, it doesn't have to be! 

Consider Activity Subcategories

Understanding the Improvement Activities subcategories can narrow down your search to the activities most relevant to your practice. Consider choosing activities that either bridge identified gaps in quality of care, or that represent activities you already perform.

• Achieving Health Equity - These activities are ideal if you are using a QCDR to report , or want to  take a look at the quality of care for your Medicaid patients.
• Behavioral and Mental Health - This category features some cross-overs with the Quality Performance Category of MIPS with activities that look at the co-morbidity of mental health and physical health conditions.  In general, these activities aim to integrate patients mental health care with their primary care setting.
• Beneficiary Engagement - As the name suggests, these activities are centered around engaging patients through post-visit surveys, tracking patient reported outcomes, effectively using care plans to manage chronic conditions, and other activities that really focus on extending health beyond the point of care.
• Care Coordination - This subcategory focuses on coordinating care between clinicians. Activities here will encourage the practice of health information exchange, documentation of care hand-offs, and coming up with coordinated care plans with commonly used consultants or specialists.
• Emergency Response & Preparedness - These  two activities are about supporting communities - either by registering to be a part of a Disaster Medical Assistance Team, or 60-day (at least) participation in an effort to support domestic or international humanitarian needs.
• Expanded Practice Access - These activities are all about being accessible to your beneficiaries, and providing them with access to care that they may need.
• Patient Safety & Practice Assessment Population Management - These activities look at patient safety monitoring programs for things including but not limited to prescription drug monitoring, falls risks , or appropriate use of antibiotics.
• Population Management - These activities revolve around population health. Participation in population health research, meaningful utilization of population health tools, and participating in CMS innovation models are examples of activities that could count for this category.

Determining the Impact to your Final Score

Improvement Activities score calculation is pretty straight forward. Each activity is assigned a weight, either medium or high. Medium-weight activities are worth 10 points, while high-weight activities are worth 20 points. Most practices will need 40 total points to receive full credit in this performance category. 

Exceptions:

• Small Practices  (less than 15) or HPSAs (Healthcare Professional Shortage Areas) are only required to report 20 points
• Participation in an Alternative Payment model is already worth 20 points, so only 20 additional points would be needed.

The Improvement Activities Performance Category is worth 15% of your total MIPS score.