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Countdown to MIPS* Data Submission Webinar Series
Let’s Talk Improvement ActivitiesDenise Hudson, NR-CMAHealth Informatics Specialist
Health Services Advisory Group (HSAG)
June 8, 2018
*Merit-based Incentive Payment System
Poll Time
Please participate in a
poll!
Respond and click [Submit] before 1:30 p.m. ET
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To Submit Questions Via Q&A:1. Click the [Q&A] option at the top
right of the presentation.
2. The Q&A panel will open.
3. Indicate that you want to send a question to the HSAG QPP Service Center.
4. Type your question in the box at the bottom of the panel.
5. Click [Send].
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Objectives
At the completion of this training, the attendee will be able to:• Select appropriate Improvement Activities to score
maximum points.• Summarize Improvement Activities scoring
methodologies.
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Acronyms Used In Today’s Presentation
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Acronym DefinitionAPM Alternative Payment Model
CEHRT Certified Electronic Health Record Technology
CMS Centers for Medicare & Medicaid Services
CE Continuing Education
EIDM Enterprise Identity Management System
EHR Electronic Health RecordEOB Explanation of BenefitsHPSA Health Professional Shortage AreaIA Improvement ActivitiesJSON JavaScript Object Notation
MACRA Medicare Access and CHIP Reauthorization Act
Acronym Definition
MIPS Merit-based Incentive Payment System
MU Meaningful Use
NPI National Provider Identifier
PCMH Patient Centered Medical Home
PI Promoting Interoperability
PQRS Physician Quality Reporting System
QCDR Qualified Clinical Data Registry
QPP Quality Payment Program
QRDA Quality Reporting Document Architecture
TIN Tax Identification Number
VBPM Value-based Payment Modifier
XML Extensible Markup Language
Today’s Presenter
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Denise Hudson, NR-CMAHealth Informatics Specialist
HSAG
Improvement Activities
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What is an Improvement Activity?
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The Improvement Activities performance category within MIPS assesses how much a practice participates in activities that improve clinical practices, enhances patient engagement in care, and increases access to care. Improvement Activities also include incentives that drive participation in certified patient-centered medical homes and alternative payment models.
Source: CMS
Improvement Activities 2018 Overview
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• Category weight– MIPS Track = 15 percent (APM Track = 20 percent)– Earn 40 points in this category to receive full category weight
• Measure inventory increased!
• Performance period 90-day minimum– Start no later than October 3, 2018
• Attest to activities that are most meaningful to your practice– A simple is all that is required to attest! – Save documentation for a minimum of six years and three
months in the event of an audit
Source: CMS
Improvement Activities 2018 Overview (cont.)
• Improvement Activities submission mechanisms include:– Attestation (EIDM Account required: https://go.cms.gov/2HIJj6V)– Qualified Clinical Data Registry – Qualified Registry– Electronic Health Record – CMS Web Interface (groups or virtual groups of 25 or more)
• If submitting data as a Group, only one clinician in the group needs to be actively engaged in the Improvement Activity
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Helpful ToolsImprovement Activity Fact Sheet: https://go.cms.gov/2khpUA2Improvement Activities Inventory: https://go.cms.gov/2lcJu1c
Source: CMS
Improvement Activities Subcategories
Choose from activities available in the Inventory that span over nine subcategories:
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• Expanded Practice Access• Population Management• Care Coordination• Beneficiary Engagement• Patient Safety and Practice
Assessment
• Participation in an APM• Achieving Health Equity• Integrating Behavioral and
Mental Health• Emergency Preparedness
and Response
Source: CMS
How Do I Earn 40 Points?Large Practice
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A large practice is defined by CMS as a practice with 16 or more clinicians under a single TIN.
High-Weighted Activity = 20 pointsMedium-Weighted Activity = 10 points
Two High-Weighted 20 + 20 = 40
Four Medium-Weighted 10 + 10 + 10 + 10 = 40
One High-Weighted and Two Medium-Weighted20 + 10 + 10 = 40
Source: CMS
How Do I Earn 40 Points?Small Practice
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A Small Practice is defined by CMS as a practice with 15 or fewer clinicians under a single TIN.
High-Weighted Activity = 40 pointsMedium-Weighted Activity = 20 points
One High-Weighted 40 points
Two Medium-Weighted 20 + 20 = 40
Burden Reduction AimSmall practices will continue to report on no more than
two activities to earn the highest score.
Source: CMS
How Do I Earn 40 Points?Special Considerations
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• Non-patient Facing Clinicians, Rural or Health Professional Shortage Area
– Report no more than two activities; same as small practice– Click here to use the NPI Look-up Tool or visit https://bit.ly/2wv9LyE
• Patient-Centered Medical Homes – Automatically receive full category weight
• MIPS APM Participants– Score automatically assigned based on the MIPS APM participated in
• No further documentation or data submission required– Click here to use the APM Look-Up Tool or visit https://bit.ly/2hOMEJE
Source: CMS
Payment Adjustment Considerations
Can your practice remain neutral in 2020
if you only complete the Improvement
Activities category in
2018?
The answer is: YES
Final Score 2018
Change Y/N
Payment Adjustment in 2020
>70points N
• Positive adjustment greater than 0%• Eligible for exceptional performance bonus
– Minimum of additional 0.5%
15.01–69.99Points
Y • Positive adjustment greater than 0%• Not eligible for exceptional performance bonus
15points Y • Neutral payment adjustment
3.76–14.99points*
Y • Negative payment adjustment greater than -5% and less than 0%
0–3.75points
Y • Negative payment adjustment of -5%
15*Adjustments in this range are based on a sliding scale
Source: CMS
Improvement Activities Inventory
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• To access the Improvement Activities Inventory: – Visit: www.qpp.cms.gov– Click [MIPS] at the top right – Select [Improvement Activities]
• Or visit the QPP 2018 Resource Library: https://go.cms.gov/2lcJu1c
Source: CMS
Improvement Activities Search Feature
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On the Improvement Activities landing page you can easily search for measures using key words, a subcategory name, or by activity weight.
Source: CMS
MIPS Data Validation Information: Using CEHRT
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MIPS Data Validation File: https://go.cms.gov/2lcJu1c (2018 version Coming Soon!)
Source: CMS
Improvement Activities Using Your EHREarn a Bonus!
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Improvement Activities that count toward a 10-point bonus in the Promoting Interoperability (PI) category:Activity ID Activity Name Weight
IA_EPA_1 Provide 24/7 Access to Eligible Clinicians or Groups Who Have Real-time Access to Patient's Medical Record HighIA_PM_2 Anticoagulant Management Improvements HighIA_PM_4 Glycemic Management Services High
IA_PM_13 Chronic Care and Preventative Care Management for Empaneled Patients Medium
IA_PM_14 Implementation of Methodologies for Improvements in Longitudinal Care Management for High Risk Patients Medium
IA_PM_15 Implementation of Episodic Care management Practice Improvements MediumIA_PM_16 Implementation of Medication Management Practice Improvements Medium
IA_CC_1 Implementation or Use of Specialist Reports Back to Referring Clinician or Group to Close the Referral Loop Medium
IA_CC_8 Implementation of Documentation Improvements for Practice/Process Improvements MediumIA_CC_9 Implementation of Practices/Processes for Developing Regular Individual Care Plans Medium
IA_CC_13 Practice Improvements for Bilateral Exchange of Patient Information MediumIA_BE_1 Use of Certified EHR to Capture Patient Reported Outcomes MediumIA_BE_4 Engagement of Patients Through Implementation of Improvements in Patient Portal Medium
IA_BE_15 Engagement of Patients, Family and Caregivers in Developing a Plan of Care MediumIA_PSPA_16 Use of Decision Support and Standardized Treatment Protocols MediumIA_AHE_2 Leveraging a QCDR to Standardize Processes for Screening MediumIA_BMH_7 Implementation of Integrated Patient Centered Behavioral Health Model (PCBH) HighIA_BMH_8 Electronic Health Record Enhancements for Behavioral Health Data Capture Medium
Source: CMS
MIPS Data Validation Information: No EHR
20 Source: CMS
Key “Improvement” Takeaways
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Download the Improvement Activities Fact Sheet, Measure Inventory, and MIPS Data Validations files
Pick measures that are appropriate for your practice Determine your reporting period
– Minimum of 90 days required Don’t forget the Promoting Interoperability
bonus for using your CEHRT to complete the Improvement Activity
Create a documentation plan that supports the activity.
Log into your EIDM account frequently!
Source: CMS
Next Learning Forum Friday Event: July 13, 2018
Summer's Here – Is Your Performance Sizzling?For additional event topics and registration information
please visit:www.hsag.com/LFF
Topics and dates are subject to change, so please check the webpage for up-to-date information.
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Resources• CMS Quality Payment Program Website
– https://qpp.cms.gov– Subscribe to the QPP ListServe
• Guide for Obtaining an EIDM Account https://goo.gl/oy3JRo• Medicare Learning Network (MLN) Learning Management System
Booklet (LMS) FAQs– https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNProducts/Downloads/LMPOS-FAQs-Booklet-ICN909182.pdf
• Associations offering credit for MLN events and training – https://www.cms.gov/Outreach-and-Education/Medicare-
Learning-Network-MLN/MLNGenInfo/CE-Associations.html
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CMS Announcements: Upcoming Webinar
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Promoting Interoperability Performance Category WebinarTuesday, June 12, 2018, 1–2 p.m. ET
Register at http://bit.ly/2kc19F7
In this no cost-webinar, CMS will:– Provide a brief overview of MIPS requirements in 2018– Discuss the renaming of Advancing Care Information to
Promoting Interoperability– Explain the Promoting Interoperability performance category
requirements for 2018– Discuss scoring for the Promoting Interoperability
performance category
CMS Announcements: Upcoming Webinar
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Using Data and Strategy to Succeed in MIPS Year Two: Advice for Solo and Small Group Practices
Tuesday, June 12, 2018, 3:30–4:30 p.m. ETRegister at https://adobe.ly/2IDdO2s
Thursday, June 14, 2018, 11 a.m.–12 noon ETRegister at https://adobe.ly/2IzsQSZ
Join one of these no-cost sessions to:– Identify available data including PQRS data and your 2017 MIPS data and
reports, and how to avoid penalties – Successfully transition from individual to group reporting, and much more
• To view past MIPS no-cost small practice webinars visit https://qppsurs.wordpress.com/resources/
CMS Announcements: Group Registration
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CMS Web Interface and CAHPS for MIPS Survey Reporting Options registration:• Opened April 1• Remains open through June 30, 2018
– CMS Web Interface: a submission mechanism available only to groups of 25 or more eligible clinicians
– CAHPS for MIPS Survey: a submission option for groups of two or more eligible clinicians only
• Can only be administered by a CMS-approved CAHPS for MIPS survey vendor
For more information visit https://goo.gl/YKcn7u
HSAG Quality Initiatives Spotlight
• Behavioral Health Initiative– Alcohol and Depression screenings among
Medicare beneficiaries– MIPS-aligned measures and activities– Bite-sized learning modules located at http://bit.ly/2jrrw9M
• Cardiac Health Initiative– 2017 Blood Pressure Treatment Guidelines and educational
materials available at http://bit.ly/2HQMFVx– June 22, 2018 Promoting the Journey Toward Successful
Smoking Cessation: Healthcare Provider Interventions Register at https://bit.ly/2IGKIiP
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HSAG Quality Initiatives Spotlight (cont.)
• Immunization Health Initiative – Consider using standing orders and
assessing patients each visit to improve immunization performance
– Access your state immunization registry to determine if patient received an immunization elsewhere
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Join HSAG QPP Community Mailing List!
• Subject: Join HSAG QPP Mailing List
• In the body of the email, please include:– Organization Name– First and Last name – Email address– City – State
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CE ApprovalThis program has been pre-approved for 1.0 CE unit for the following professional boards:• National
o Board of Registered Nursing (Provider #16578)
• Floridao Board of Clinical Social Work, Marriage &
Family Therapy and Mental Health Counseling o Board of Nursing Home Administratorso Board of Dietetics and Nutrition Practice Councilo Board of Pharmacy
Please Note: To verify CE approval for any other state, license, or certification, please check with your licensing or certification board.
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CE Credit Process
2. Once you have registered in the LMC, you must complete the evaluation that will appear in WebEx at the conclusion of the webinar.a. Following the event, please do not close the WebEx evaluation window.
You will not be able to access the evaluation and request CE if you close the window.
b. CEs are only available to attendees that participate in the “live” event.c. If for some reason you completed the evaluation and do not have the link
to the new user registration, please refer to Step #1 or contact Debra Price at [email protected] for CE certificate questions.
1. Register at http://bit.ly/2IAh7n5in HSAG’s Learning Management Center (LMC).
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CE Credit Process (cont.)
Following the conclusion of the webinar, you will also receive a “Thank You for Attending” email using the email address provided during registration. You will be requested to register in the HSAG Learning Management Center (LMC). • This is a separate registration from WebEx.• Please use your personal email so you can receive
your certificate.• Your organization may have firewalls up that block
our certificates.
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CE Credit Process: Existing User
To login to your existing LMC account visit http://bit.ly/2LihoNn.
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CE Certificate Problems
• If you do not immediately receive a response to the email that you signed up with in the Learning Management Center, you have a firewall up that is blocking the link that was sent.
• Please go back to the New User link and register your personal email account.
— Personal emails do not have firewalls.
• Contact Debra Price at [email protected] for CE certificate questions and or issues.
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Poll
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QPP Practice Perspective
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Hernan R. Baquerizo, MD, PASolo PhysicianMiami, Florida
Endocrinology–Diabetes–Internal Medicine
IA_PM_4 Glycemic Management Services:
Creating a Customized Diabetes Treatment Plan
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To Submit Questions Via Q&A: 1. Click the [Q&A] option at the top
right of the presentation.
2. The Q&A panel will open.
3. Indicate that you want to send a question to the HSAG QPP Service Center.
4. Type your question in the box at the bottom of the panel.
5. Click [Send].
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Thanks for Attending!
HSAG QPP Technical Assistance LineToll free: 1.844.472.4227
Monday–Friday 8 a.m. to 8 p.m. ETHSAG QPP Email Support: [email protected]
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This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, under contract with the Centers for Medicare &
Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. QN-11SOW-D.1-06052018-01.
