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Medicare will reward physicians who complete 'quality improvement' CME as part of their new value-based payment system.
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What is Quality IMprovement CME?
The CME Coalition has championed the Centers for Medicare and Medicaid Services (CMS) for recognizing Quality Imprvement continuing medical education (QI-CME) as a Clinical Practice Improvement Activity (CPIA) under the new Merit-Based Incentive Payment System (MIPS) — a physician reimbursement system which is part of the Quality Payment Program (QPP) created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
Under MACRA, physicians who do not participate in a qualifying alternative payment models (APM) will be subject to adjustments in their reimbursement under MIPS. MIPS is based on a 100-point score, with clinical practice improvement activities (CPIA) representing 15 percent of the score. The CME Coalition and other stakeholders have long advocated that CME should be included in the CPIA measurement category, as these courses are among the most important ways in which doctors seek to improve their understanding of new treatments and therapies, improve beneficiary outcomes, and ultimately, improve their practice as a whole.
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. Accredited CME providers can use The Accreditation Council for Continuing Medical Education's (ACCME) Program and Activity Reporting System (PARS) to indicate that a CME activity meets the requirements of a MIPS Improvement Activity. Activities in PARS that are flagged as MIPS activities will then be displayed in CME Finder.
Under MACRA, physicians who do not participate in a qualifying alternative payment models (APM) will be subject to adjustments in their reimbursement under MIPS. MIPS is based on a 100-point score, with clinical practice improvement activities (CPIA) representing 15 percent of the score. The CME Coalition and other stakeholders have long advocated that CME should be included in the CPIA measurement category, as these courses are among the most important ways in which doctors seek to improve their understanding of new treatments and therapies, improve beneficiary outcomes, and ultimately, improve their practice as a whole.
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. Accredited CME providers can use The Accreditation Council for Continuing Medical Education's (ACCME) Program and Activity Reporting System (PARS) to indicate that a CME activity meets the requirements of a MIPS Improvement Activity. Activities in PARS that are flagged as MIPS activities will then be displayed in CME Finder.
Accredited CME 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.
Action Steps for CME Providers
The MIPS Improvement Activity criteria are well-aligned with existing 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. ACCME has 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.
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. ACCME has 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.
Resources
The following resources are available on the CMS website:
- Improvement Activities Requirements: Overview that includes guidance for submitting Improvement Activities
- Quality Payment Program Overview
- 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
A Primer on QI-CMEIn a recent session at CMEpalooza, the CME Coalition's Andrew Rosenberg and Tom Sullivan share their their insights and provide practical guidance on how to design and allow physicians to get credit from the Centers for Medicare & Medicaid Services (CMS) for certain CME activities.
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Step-by-Step Guide to Implementing Accredited CME Improvement Activities
QI-CME offers an opportunity for providers to demonstrate the value of CME in promoting clinician engagement in efforts to improve performance, quality, and safety. The Accreditation Council for Continuing Medical Education (ACCME) has created a step-by-step guide to assist you and your learners with this opportunity.
| ACCME Step-by-Step Guide to Implementing Accredited CME Improvement Activities |
