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2020 MIPS IA_PM_2: Anticoagulant Management Improvements

Activity ID

IA_PM_2

Activity Weighting

High

Subcategory Name

Population Management

Activity Description

Individual MIPS eligible clinicians and groups who prescribe anti-coagulation medications (including, but not limited to oral Vitamin K antagonist therapy, including warfarin or other coagulation cascade inhibitors) must attest that for 75 percent of their ambulatory care patients receiving these medications are being managed with support from one or more of the following improvement activities:  

  • Participation in a systematic anticoagulation program (coagulation clinic, patient self-reporting program, or patient self-management program);
  • Patients are being managed by an anticoagulant management service, that involves systematic and coordinated care, incorporating comprehensive patient education, systematic prothrombin time (PT-INR) testing, tracking, follow-up, and patient communication of results and dosing decisions;
  • Patients are being managed according to validated electronic decision support and clinical management tools that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions;
  • For rural or remote patients, patients are managed using remote monitoring or telehealth options that involve systematic and coordinated care, incorporating comprehensive patient education, systematic PT-INR testing, tracking, follow-up, and patient communication of results and dosing decisions; or
  • For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program.

Validation

Documented participation of patients being managed by one or more clinical practice improvement activities. Could be supported by claims. Anticoagulation services may consult with patients over the phone, recommending dosage changes and setting dates for follow-up lab work and may also consult with the patient’s personal physician or specialty physicians in complex cases.

Suggested Documentation

1) Patients Receiving Anti-Coagulation Medications - Total number of outpatients prescribed oral Vitamin K antagonist therapy; and
2) Percentage of that Total Being Managed By a Clinical Practice Improvement Activity - Number of outpatients prescribed oral Vitamin K antagonist therapy and who are being managed by one or more of the four activities in the described in the activity description; and
2) Documentation plan to address patients' language and communication needs, literacy level, and cognitive and functional limitations.

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