Healthmonix Advisor

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! 

One of the trickiest aspects of the new CMS Quality Payment Program is understanding how to report MIPS as a group. MIPS group reporting is when a TIN of 2 or more providers decides to report their MIPS measures and activities on the group (TIN) level, rather than on the individual (TIN+NPI) level. This could be an advantage to a practice that has a few providers who struggle to find measures that are relevant to them personally, or a practice exercising the "test option" of MIPS reporting for 2017. Eligible Clinicians must report either individually or as a group consistently across all MIPS performance categories.

House Republicans narrowly passed their long-promised Affordable Care Act repeal and replacement bill this Thursday. The American Healthcare Act barely scraped by with a vote of 217-213, with all 2017 "yes" votes coming from Republican Representatives. Although 20 Republican Representatives still opposed the bill, the revisions were able to convert 23 hard line conservatives into voting favorably. This proved enough for passage.

The Improvement Activities Performance Category is a new concept introduced by MIPS reporting and rewards eligible clinicians for participating in activities related to their patient population. Clinicians and groups can choose to participate in activities most relevant to both their practice and patient population. The Improvement Activities Performance Category is worth 15% of the MIPS Composite Performance Score in 2017.

The Advancing Care Information (ACI) Performance Category is Meaningful Use updated to be more flexible, customizable, flexible and focused on patient engagement and interoperability. ACI is worth 25% of your MIPS Composite Performance Score.

The Quality Performance Category

The Quality Performance Category is one of four Performance Categories to be reported for the Merit-Based Incentive Payment System (MIPS). Carrying the highest weight of the four Performance Categories, the Quality Score will determine 60% of the MIPS Composite Performance Score for eligible clinicians or groups.

Although the president has stated that he is moving on to other issues, the GOP remains hopeful that they will dismantle and replace the Affordable Care Act (ACA) in the not-too-distant future. The Republican's proposed replacement bill, the American Health Care Act (AHCA) was withdrawn last Friday as it lacked the votes to pass. Under pressure from conservative activists this week, House Republicans and the White House have renewed their efforts to repeal the Affordable Care Act and replace it with their own bill.

This week, house Republicans introduced the long-anticipated Obamacare replacement plan. This plan, called the American Healthcare Act (AHCA), has received a high level of criticism already from a surprising mix of people. Although it certainly is too soon to tell, it seems as if the bill will likely not pass before significant edits are made.

The Advancing Care Information Performance Category will be replacing the EHR Incentive Program (colloquially known as Meaningful Use) for 2017 performance year, as a part of the Merit-Based Incentive Payment System (MIPS). One of three performance categories to be scored for 2017 reporting, ACI will be worth 25% of your total MIPS Composite Performance Score. Non-physician eligible clinicians, hospital-based eligible clinicians, and non-patient facing eligible clinicians are considered ineligible for Advancing Care Information, and will have this performance category automatically re-weighted to zero.

The MIPS Quality Performance Category is replacing PQRS reporting in 2017, folding it into the Merit-Based Incentive Payment System. The Quality portion will comprise 60% of an eligible clinician's MIPS Composite Performance Score for 2017.  To calculate that score, there is significant math involved.  This article will walk you though the calculations and logic used to determine your Quality score, but it is important to note that many data submission vendors will automatically give you a predictive calculation.