The Centers for Medicare & Medicaid Services (CMS) include accredited CME as an improvement activity in the Quality Payment Program (QPP). This offers an opportunity for providers to demonstrate the value of CME in promoting clinician engagement in efforts to improve performance, quality, and safety.
Accredited CME providers can support their clinician learners in several ways: you can help clinicians understand how to identify improvement activities, facilitate those activities, and then assist clinicians in attesting to their participation; and you can plan and present CME activities that will count as improvement activities.
Improvement Activity Criteria
To meet the criteria for improvement activities in the Merit-Based Incentive Payment System (MIPS) of QPP, accredited CME providers need to implement activities that:
- address a quality or safety gap that is supported by a needs assessment or problem analysis, or support the completion of such a needs assessment as part of the activity;
- have specific, measurable aim(s) for improvement;
- include interventions intended to result in improvement;
- include data collection and analysis of performance data to assess the impact of the interventions; and
- define meaningful clinician participation in their activity, describe the mechanism for identifying clinicians who meet the requirements, and provide participant completion information.
You can find the criteria described above in the PDF of the final rule on page 623.
ACCME Accreditation Criteria
The MIPS improvement activity criteria are well-aligned with the ACCME Accreditation Criteria and may align with your CME mission and program. You may already be delivering activities that will fulfill the criteria. Delivering CME that counts for MIPS within the already existing framework of a clinician’s educational home could streamline and demystify the process for clinician participation.
The MIPS criteria are also aligned with the American Board of Internal Medicine (ABIM) Practice Assessment Maintenance of Certification (MOC) requirements. This offers another opportunity for CME providers to ease the burden on clinicians by delivering activities that meet multiple expectations. Providers can offer activities that enable clinicians to earn CME credits and ABIM Practice Assessment MOC points—and those same activities can count for MIPS. More information about CME that Counts for ABIM MOC is available here.
We suggest that accredited providers:
- Review the MIPS improvement activity criteria described in the bulleted list above.
- Review the letter ACCME sent to CMS about how accredited CME can support MIPS goals. The letter includes a few examples of accredited CME activities that focus on quality and performance improvement and appear to meet MIPS expectations.
- Identify activities that you are designing to change performance or patient outcomes. (ACCME Accreditation Criterion 3)
- Identify activities that will be part of a quality improvement initiative for individual clinicians or for small or large groups.
- Identify activities that will be offered for ABIM Practice Assessment MOC points.
- Consider teaching clinicians how to implement quality measures into their practice and supporting them in implementing these performance improvement programs.
The following resources are available on the CMS website:
- MIPS Improvement Activities Fact Sheet: Overview that includes guidance for submitting improvement activities
- Quality Payment Program Fact Sheet: Overview of Quality Payment Program Year 2 Final Rule
- Quality Payment Program Resource Library: Resources including specific information about MIPS measures by clinician profession
- Merit-based Incentive Payment System: 3 Ways to Participate in 2017: Infographic that summarizes three ways to participate in 2017 and includes links to additional resources
- Quality Payment Program website: Overview of eligibility and participation guidelines, with links to additional resources
The American Academy of Family Physicians (AAFP) published a list of acronyms and definitions on its website: MACRAnyms: Acronyms and Terms Related to MACRA.