Outrunning The MIPS Bear in 2019: Improvement Activities Portion

Last year, Improvement Activities (IA) was a spanking brand-new category, and as such was self-attest: simple.  This year, it’s more like Promoting Interoperability (PI): you’ve got to choose and submit actual numbers from actual reports.  Well, there it is so let’s have at it!

As stated previously, there are 4 categories to consider while running away from Da Bear: 1) Quality, 2) Promoting Interoperability (PI), 3) Improvement Activities (IA), 4) Cost.

Of the 4, Improvement Activities (IA) represents 15% of the final score.

All right, then, CMS (qpp.cms.gov), says that IA “measures participation in activities that improve clinical practice.”

CMS further says I ought to figure out if I qualify for ‘special status’, such as a ‘small practice’ and I do, so not only will I receive double points for each high and medium weighted activity, I furthermore have a reduced reporting burden of one high-weighted activity and 2 medium-weighted activities.  Now we’re talking!  I like that – if I didn’t qualify for special status (I’m feeling special, like everybody else), I’d have to report on 9, count ‘em nine, activities.

And the wrinkle, for being awarded special status?  Always be aware that when you report the minimum required you start falling back through the pack running from Da MIPs Bear: have more of an over-achiever mindset and report all applicable measures to stay more towards the front of the pack.

Again at qpp.cms.gov, working the filters, an old hand at this by now, I come up with a combination of weighted activities that best suit my practice and EHR reporting capability when it comes to IA.

I pick a combination of the following activities:


Weight CMS/NQF

EHR Documentation process

Provide 24/7 access to MIPS eligible clinicians

High N/A Caretracker operator access logs, Direct email logs
Depression Medium CMS2v6 Medical record>HX
Tobacco Use Medium CMS138v5

Medical record>HX


And there’s my Improvement Activities (1 high weighted, 2 medium weighted).  The reason I picked Depression and Tobacco use categories: I know exactly where in my EMR I can both document and produce the relevant reports when necessary: good for me, no?

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Brad Sclar has founded several successful Healthcare IT companies within the last 20 years in the Denver area — PRS Network, Phasis Group, and MD-IT. In addition to multiple IT certifications he supports voice recognition software into multiple EMR environments nationwide, serves as the CIO of the PRS IT Division, overseeing template development, maintenance of client LAN installations, custom software development, HL7 interfaces between EMRs, and the installation of the Health Record portion of the EMR software packages that PRS represents. Currently, he is involved in launching a Urology focused MSO.