The Centers for Medicare & Medicaid Services (CMS) include accredited CME as an improvement activity in the Merit-Based Incentive Payment System (MIPS) of 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.
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.
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 fulfill the MIPS criteria, as well as fulfilling requirements for Maintenance of Certification and other professional expectations. 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. Here are action steps to consider that may help you to support your learners and your organizations as they navigate payment reform.
Use CME activities to help clinicians meet MIPS expectations that deliver financial incentives for engaging in quality. This year, MIPS-eligible clinicians can report participation in CME activities that address performance and/or quality improvement to fulfill MIPS Clinical Practice Improvement Activities. These improvement activities are included in the current (PY2018) Clinical Practice Improvement Activities and are listed as Completion of An Accredited Safety or Quality Improvement Program (Activity ID IA_PSPA_28) under the Patient Safety and Practice Assessment category on the QPP website. We have posted a step-by-step guide to assist you and your learners with this opportunity.
Support organizational change with CME. A recent KPMG/AMA survey highlights significant gaps in knowledge for physicians seeking to understand and plan for meeting the expectations of the QPP. These educational needs may highlight an opportunity for you to convene a conversation with your leadership about how your CME program can support organizational learning that engages physicians, healthcare teams, and administrators around these changes. This interprofessional education can support organization-wide professional development to build leadership and communication skills essential for implementing change.
Quality-improvement is CME. Pursue collaboration with colleagues in your organization who monitor and report CMS performance and quality measures. At a minimum, those data can inform the gaps and educational needs of your interventions and measure the impact of your educational efforts. Engage leadership to remove silos and more effectively envision quality improvement and continuing professional development as a learning continuum.
CME for MIPS is one way that you can relieve administrative burden for your clinicians. In addition to MIPS, several strategic opportunities exist to allow your learners to simultaneously satisfy several professional and institutional requirements through their current engagement in CME learning and improvement. Consider engaging with your clinicians and organizational leaders to communicate specific ways that your CME Program can simplify professional requirements and reduce administrative burden—from quality improvement to MIPS to Maintenance of Certification/Continuing Certification.
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
- 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.