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2021 MIPS IA_PSPA_17: Implementation of analytic capabilities to manage total cost of care for practice population

Activity ID

IA_PSPA_17

Activity Weighting

Medium

Subcategory Name

Patient Safety and Practice Assessment

Activity Description

In order to receive credit for this activity, a MIPS eligible clinician must conduct or build the capacity to conduct analytic activities to manage total cost of care for the practice population. Examples of these activities could include:

  1. Train appropriate staff on interpretation of cost and utilization information;
  2. Use available data regularly to analyze opportunities to reduce cost through improved care. An example of a platform with the necessary analytic capability to do this is the American Society for Gastrointestinal (GI) Endoscopy’s GI Operations Benchmarking Platform.

Objective

Create opportunities to assess total cost of care and identify ways to reduce unnecessary costs.

Suggested Documentation

Evidence of use or building of analytic capabilities to manage the total cost of care for the practice population. Include at least one of the following elements:

1) Staff training – Documentation of staff training on interpretation of cost and utilization information (e.g., training documentation); OR
2) Cost/resource use data – Availability of cost/resource use data for the practice population that the practice uses regularly to analyze opportunities to reduce cost; OR
3) Participation in regional Total Cost of Care efforts – Engage with local Regional Health Improvement Collaborative (RHIC) to measure and utilize Total Cost of Care (TCoC) to identify opportunities for practice improvement, create a practice improvement plan(s), and execute on the plan(s). Documentation may include communication with RHIC (e.g., email) or a copy of TCoC report(s).

Example/Information

• The American Society for Gastrointestinal (GI) Endoscopy’s GI Operations Benchmarking Platform is an example of a tool used for identifying opportunities to reduce cost: https://www.asge.org/home/practice-support/gi-operations-benchmarking
• The Network for Regional Healthcare Improvement representing regional healthcare collaboratives has information about RCoC: https://www.nrhi.org/

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