Activity ID
IA_PM_18Activity Weighting
MediumSubcategory Name
Population Management
Activity Description
Engaging community health workers to provide a comprehensive link to community resources through family-based services focusing on success in health, education, and self-sufficiency. This activity supports individual MIPS eligible clinicians or groups that coordinate with primary care and other clinicians, engage and support patients, use of health information technology, and employ quality measurement and improvement processes. An example of this community based program is the NCQA Patient-Centered Connected Care (PCCC) Recognition Program or other such programs that meet these criteria.
Validation
Evidence of engagement with community health workers to provide a comprehensive link to community resources and family-based services with an emphasis on improving health, education, and self-sufficiency
Suggested Documentation
1) Documentation of engagement with community health workers; and
2) A demonstrated link to community resources that promote family-based services i.e. paper work, notes, etc.; and
3) Documentation of coordination with primary care and other clinicians to engage and support patients, use of health information technology, and employ quality measurement and improvement processes, e.g. NCQA Patient-Centered Connected Care (PCCC) Recognition Program or similar programs.
Examples of Additional Activities that Qualify for Attestation
Completing these alternate activities can fulfill the requirements of this Improvement Activity; and Notes
Sub IA_1: Provide Community Linkages for Patients with HIV+ Status