Understanding the Value of Improvement Activities

Under the Merit-based Incentive Payment System (MIPS), the Improvement Activity (IA) category is one of four components designed to evaluate processes in clinical practice such as ongoing care coordination, patient shared decision making, clinical safety practices, and expanded patient access. For the performance year 2018, MIPS clinicians have access to 100+ activities to select from to demonstrate their performance.

To earn full credit (i.e., up to a maximum of 15% of your MIPS Score) in this category, a combination of either high-weighted (20 points) or medium weighted (10 points) activities are required for at least a continuous 90-day period up to a full calendar year. Providers in groups that are small practices (15 or fewer clinicians) only need to earn 20 points. All other practices with more than 15 providers need to earn 40 points.

Healthcare providers have many questions about the use, data collection, and implementation of Improvement Activities. Providers are seeking clarity and asking

  • What are Improvement Activities?
  • What type of documentation is required to support the activities?
  • What is the timeframe for implementing and monitoring outcomes?
  • How will this initiative add value to my daily workflow of practice?

All of these questions are legitimate; it is essential to understand the value of improvement activities. When executed, these activities lead to improvements in measured performance.

An example of an Improvement Activity is the collection and use of patient experience and satisfaction data on access.

Before the addition of IA to MIPS, one of my clients — Dr. Philip Fischer — had never utilized patient surveys to improve the delivery of care. Earlier this year, his team started a patient experience campaign in which they collected data for the timeframe of 90-days. Surprisingly, the most common statement received from patients was the need to improve timely communication for pre-operative instructions. The team immediately created and implemented a policy for prompt communication. As a result of this improvement plan, patients are now complimenting the team daily, and their satisfaction scores have increased. Until now, Dr. Fischer had not measured patient experience on access. Today, he understands the value of continuous process improvement. His team is passionate and will continue to move in this direction.

Understanding the value of Improvement Activities is vital to transforming practices. The purpose of the IA category is to transition providers toward coordinated and more patient-centered care. Many of the activities reflect the quality standards of the Patient-Centered Medical Home model of care. Continuous quality improvement is a journey and will not happen overnight. Therefore, providers should adopt a culture of improvement and evaluate the way they deliver care.


April Richardson, MSM
Healthcare Quality Consultant