APMA News - September/October 2016 - 25

Clinical Performance Improvement Activities Unlike the Quality, RU, and ACI performance categories, the CPIA category has no predecessor CMS program. This new category was mandated by law8 and is intended to promote ongoing improvement and innovation in clinical activities such as care coordination, shared decision-making, safety checklists, and expanded access to care. A physician may choose to participate in one or more activities best suited to his or her own practice, chosen from more than 90 options compiled by CMS.9 Each activity is designated as either medium (10 points) or high weight (20 points), and a maximum of 60 points can be earned in the CPIA category. Some special scoring rules also apply to the CPIA category including: a physician participating in a recognized or accredited patient-centered medical home or a comparable specialty practice automatically receives full CPIA credit (60 points);10 a physician participating in an APM automatically receives half credit (30 points); and a physician practicing in a small group (<15 members), or in a rural or geographic health professionals shortage area (HPSA) automatically earns half credit (30 points) * * * continued on page 26 8 MACRA, P.L. 114-10, enacted April 15, 2015. 9 See Table H of the proposed rule for details. 10 Acceptable medical home recognition may come through programs offered by the Accreditation Association for Ambulatory Health Care, the National Committee for Quality Assurance (NCQA), The Joint Commission Designation, or the Utilization Review Accreditation Commission. NCQA also offers Patient-Centered Specialty Recognition that CMS proposes to recognize as comparable to the medical home designation. Table 1. Example of Possible APMA Member Quality Measures PQRS NQF Title NQS Domain Type Developer eCQM/ CQM 110 0041 Preventive Care and Screening: Influenza Immunization Community/ Population Health Process AMA eCQM 111 0043 Pneumonia Vaccination Status for Older Adults Community/ Population Health Process AMA eCQM 126 0417 Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy-Neurological Effective Clinical Care Process APMA CQM 127 0416 Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention-Evaluation of Footwear Effective Clinical Care Process APMA CQM 128 0421 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan Community/ Population Health Process CMS eCQM 154 0101 Falls: Risk Assessment Patient Safety Process NCQA CQM 155 0101 Falls: Plan of Care Communication and Care Process NCQA CQM 226 0028 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Community/ Population Health Process AMA eCQM 317 - Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented Community/ Population Health Process CMS eCQM - - Comprehensive Diabetic Foot Examination Process APMA eCQM - - CDR 2: Diabetic Foot Ulcer Healing or Closure Outcome US Wound Registry eCQM APMA News September/October 2016 25

Table of Contents for the Digital Edition of APMA News - September/October 2016