CMS (Centers for Medicare and Medicaid Services) highly regards the improvements activities in clinical practices. It adds value to the quality of healthcare services and eventually increases the performance of your revenue cycle. QPP MIPS, therefore, incentivizes all those MIPS eligible clinicians who pay attention to minor quality details while treating patients.
Today, we will review Improvement Activities (IA) reporting
requirements in MIPS data submission to CMS.
IA Reporting Requirements 2021
As you know, reporting requirements change every year due to
advancements in the healthcare industry, and for the 2021 performance year, IA
weighs 15% of the total MIPS score. It is also to remember that there are no
additional reporting requirements under the APM Performance Pathway (APP).
What IA Data is to Report to CMS?
To earn recognition and points in this category, MIPS eligible clinicians must report MIPS Quality Measures for:
- 2 high-weighted activities
- 1 high-weighted activity & 2 medium-weighted activities
- 4 medium-weighted activities
The only requirement is to perform improvement activities
during 90 consecutive days.
How can Groups Submit IA Data?
Groups, virtual groups, and APM entities can attest to any
activity if at least 50% of them perform the same activity. However, they don't
need to indulge in activities at the same time.
How can Physicians Submit Data?
Depending on your MIPS data submission type, generally,
clinicians can report in three ways.
·
Sign in and attest
·
Sign in and upload
·
Direct submission via API
Here is a table depicting which type qualified for which submission method.
|
Submitter Type |
Sign in & Attest |
Sign in & Upload |
Direct Data Submission |
|
MIPS Eligible Clinician |
Yes |
Yes |
No |
|
Group, Virtual Group, APM Entity |
Yes |
Yes |
No |
|
Third-Party Intermediaries |
No |
Yes |
Yes |
However, the best method is to
consult a MIPS Qualified Registry and get free from the administrative load.
How CMS Score Your Performance?
CMS has the following criteria to gauge performance in the Improvement Activities (IA).
- 20 points for High-weighted activities
- 10 points for Medium-weighted activities
Benefits for Special Status in IA Reporting
If any individual clinician,
virtual group, or group has a special status, they receive double points for
high and medium-weighted activities.
What is in Store for APM Participants?
APM (Alternative Payment Model)
clinicians participating in the QPP MIPS will receive 50% of the credit for
their Improvement Activities.
How Patient-Centered Medical Homes Report for MIPS 2021?
The Patient-Centered Medical Homes
or Specialty practice participants can earn maximum points in this category if
they report timely. However, it is to note that healthcare organizations with
multiple practice sites must have at least 50% recognized or certified
locations for patient-centric medical homes.
What are the Reporting Criteria for QPP MIPS Data Attestation for Patient-Centered Medical Homes?
Patient-Centered Medical Homes can become eligible for reporting if they meet one of the following requirements.
- Accreditation from a nationally accredited and well-reputed organization
- Participant of Medicaid Medical Home Model or Medical Home Model
- A comparable specialty practice with recognition through a specialty recognition program via a nationally recognized accreditation organization
- Accreditation from a certifying body that certified a large number of medical organizations and complies with the national guidelines issued by the Secretary
Given below is the list of nationally recognized accreditation organizations.
- The Joint Commission
- The Compliance Team (TCT)
- The National Committee for Quality Assurance (NCQA)
- The Utilization Review Accreditation Commission (URAC)
- The Accreditation Association for Ambulatory Health Care
