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Improving Improvement Activities for the Quality Payment Program

Wednesday, November 28, 2018   (0 Comments)
Posted by: Bevin Rousopoulos
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Improving Improvement Activities for the Quality Payment Program


As CMS’ Quality Payment Program (QPP) enters year three, participating in Improvement Activities (IA) remains an important component, accounting for 15 percent of Merit-Based Incentive Payment (MIPS) scores. Yet the IA component is one of the most challenging MIPS components to implement due to its complexity.

 

At the PCPI Fall Conference 2018, participants shared what works and what does not, in getting IA programs up and running, and what they would like to see changed. We invite you to add your experience and insights with IAs, as PCPI staff prepare a summary report on the real-world impact of IA requirements on care quality, practice operations and reimbursement, as well as recommendations for enhancing the value of improvement activities. Please share your experience with IA by November 30th. The results of which will be shared at the end of the year.


 

Top Improvement Activity Clinician Education Methods

 

Educating MIPS-eligible clinicians on what IA activities are eligible for reporting under CMS rules, how they must be reported, their potential for improving patient outcomes and their impact on reimbursement are critical for success. Conference participants reported a variety of successful approaches combining electronic and individualized approaches, including:

 

  • Online resources, such as internal webinars and links to materials from specialty societies and CMS.

  • Customized interaction, such as one-on-one clinician consulting and mentoring, using real-world registry data for education, identifying improvement activities relevant to specific specialties, clarifying specific documentation requirements, and quality improvement tours and seminars to better acquaint clinicians with internal practices, processes and resources

  • Ongoing news and advice, such as newsletters, podcasts, case studies, fact sheets and ask-the-experts at specialty meetings


 

Top Improvement Activity Challenges

 

With more than 120 specific IAs identified by CMS, and these divided into eight categories with high and medium weighting that must be combined in different ways to come up with a final IA score, issues related to complexity were most often mentioned as barriers. These included vague requirements and standards, burdensome reporting, and the presence of too many improvement activities and categories.

 

At the same time, many participants noted that there are not enough IAs that are relevant for some specialties to effectively participate. Similarly, another key issue was the lack of sufficient ties between IAs and performance improvement priorities.

 

 

Top Improvement Activity Benefits

 

Nonetheless, many conference participants acknowledged that the IA reporting requirement had a positive impact on their organizations. These included better patient care, incentive to participate in clinical registries and raising awareness of and participation in quality improvement programs. Receiving credit for activities clinicians already do, such as adhering to care coordination guidelines, was another plus.


 

Top Changes to Improve Improvement Activities

 

Not surprisingly, IA program changes participants favored reflected the issues they experienced in 2017 and 2018. These included:

 

  • CMS clarifying requirements for IA reporting and providing more-specific feedback on IA proposals

  • Increase relevance of IA by streamlining categories, developing more specialty-specific measures and categories, and strengthening ties between IA and performance measures. Several suggested focusing on developing fewer IA descriptions that focus on broader meaningful outcomes, giving practices more flexibility to meet them

  • Share best practices and incorporate a formal change process for revising IAs

 

 

Top Actions PCPI Can Take

 

Conference participants felt that a platform to share IA best practices and case studies was important. In response, PCPI staff are developing a plan.

Again, we also invite your input by filling out the linked form and returning it by November 30th. To share your experiences and input with IA.