Improvement Activities is the third performance category in the Merit-based Incentive Payment System in 2021 and counts for 15% of the Final Score. By definition, these are activities that are likely to result in improved outcomes if providers participate in them. The 2021 final rule presents many improvement activities to choose from with the goal being for the provider to choose ones that align with their practice and patient base.
How are Improvement Activities Scored?
Each improvement activity has received a “weighting” from CMS. That weighting, “high” or “medium”, is determined based on how the particular activity aligns with CMS or national public health priorities. Each weighting is assigned a point value:
- High-weighted activity: 20 points
- Low-weighted activity: 10 points
To receive maximum credit in the Improvement Activities category, the clinician must reach 40 total points. This can be met through any combination of high and/or low-weighted activities. Importantly, clinicians in small practices (defined as ≤ 15 providers) will continue to have the point values assigned to high and low-weighted activities doubled in 2020. This means that a clinician in a small practice would only need to accomplish one high-weighted activity or two medium-weighted activities for full credit in the Improvement Activities performance category.
If a clinician scores less than 40 points, they would receive a percentage of the 15 total possible points in the Improvement Activities category. For example, a clinician who achieved one “medium” weighted activity (20 points) and nothing else, would receive 50% (20 being 50% of 40) of the 15 total possible points. The scores assigned to the weightings and needed for maximum credit within this category are subject to change in future performance years.
A clinician can consider an improvement activity satisfied once they have successfully participated in it for 90 consecutive days. To review the list of available activities for 2020 and their guidelines, please visit the tool on the Quality Payment Program website. Note that each activity description has its weighting specified in the listing: See Example
Reporting for the Improvement Activities category will be via a Yes/No attestation. It will be important that clinicians assemble and maintain appropriate documentation of their participation in activities in order to support themselves in the event of a MIPS audit.