• MIPS Improvement Activities—What’s New for 2019

    Written By: Rebecca Hancock, Chris McDonagh, Molly Peltzman, and Jessica Peterson, MD, MPH

    Excerpted from “MIPS—What’s New for 2019”, a two-part EyeNet series (January and February, 2019) published online ahead of print. You also should bookmark EyeNet's MIPS 2019 (also published online ahead of print) and the Academy's MIPS hub page.


    The improvement activities performance category remains largely the same—though 10 additional improvement activities are available to report via the IRIS Registry, including one for eye exams. 

    An improvement activities score of 100% is no longer enough to avoid the payment penalty. As in 2018, if your 2019 improvement activities score is 100%, you will earn 15 points toward your MIPS final score. In 2018, that would have been enough to avoid a future MIPS payment penalty, but not in 2019. Because the threshold for avoiding penalty has increased to a MIPS final score of 30 points, you should also try to score points for quality measures and/or promoting interoperability measures.

    Improvement activities no longer contribute to your PI score. In 2018, certain improvement activities would earn you a PI bonus if you used certified EHR technology (CEHRT) to help you perform those activities. This is no longer the case in 2019.

    Ten improvement activities have been added to the IRIS Registry. When you report improvement activities manually via the IRIS Registry, you can choose from 34 activities (up from 24 in 2018).

    Two of the additions are high-weighted improvement activities:

    Eight of the additions are medium-weighted improvement activities:

    Performing the eye exam improvement activity (IA_AHE_7). According to CMS, this medium-weight activity is intended for:

    • “1) nonophthalmologist/optometrists who refer patients to ophthalmologists/ optometrists,” 
    • “2) ophthalmologists/optometrists caring for underserved populations at no cost” (our emphasis)
    • “3) any clinician providing literature and/or resources on this topic.”

    Participating in EyeCare America could help you satisfy the “no cost” requirement for this improvement activity. The Academy’s EyeCare America program helps seniors who have not had a medical eye exam in three or more years, and those at increased risk for glaucoma, access eye care. You can make a big difference in the lives of these patients, with a minimal time commitment and without leaving your office. To find out how it works, visit aao.org/volunteer.

    Please note: CMS also states that the eye exam improvement activity “must be targeted at underserved and/or high-risk populations that would benefit from engagement regarding their eye health with the aim of improving their access to comprehensive eye exams.”

    Explore the improvement activites: See 34 improvement activities that can be reported via the IRIS Registry for the 2019 performance year.

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