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  • MIPS 2023—Improvement Activities: How to Report Activities

    This content is excerpted from EyeNet’s MIPS 2023: A Primer and Reference; also see the Academy’s MIPS hub page.

    Decide how you will attest. You can attest to your improve­ment activities performance via the IRIS Registry, the CMS QPP portal, or possibly your EHR vendor (ask your vendor whether it offers this option and what fees are involved).

    Attest that you successfully completed improvement ac­tivities. However you decide to attest, it is your responsibility to attest that you appropriately completed the improvement activities that you choose to perform. If you attest via a third party (e.g., the IRIS Registry), the third party simply reports to CMS what you attested—the third party is not confirming that you did in fact complete those activities.

    Group-level reporting. Practices that report as a group will only score points for an improvement activity if at least 50% of the practice’s clinicians meet the reporting require­ments of that activity (e.g., in a practice of nine, at least five). They must do each activity for a performance period of at least 90 consecutive days, but they don’t all have to do it during the same date range.

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    Next: Select, Perform, and Document Your Activities

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    All of the American Academy of Ophthalmology-developed quality measures are  copyrighted by the AAO’s H. Dunbar Hoskins Jr., MD, Center for Quality Eye Care (see terms of use).