2023 MIPS IA_PM_2: Anticoagulant management improvements

Activity ID

Activity Weighting

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.

Objective

Improve patient understanding and adherence while reducing the risk of medication errors and adverse drug events.

Suggested Documentation

Evidence of participation by patients who have anti-coagulation medication prescriptions in one or more of the clinical practice improvement activities listed in the Activity Description. Include all of the following elements:

1) Patients receiving anti-coagulation medications – Total number of outpatients prescribed oral Vitamin K antagonist therapy (e.g., claims, electronic health record report); AND
2) Percentage of that total being managed by one of the methods of care in the Activity Description – Number of outpatients prescribed oral Vitamin K antagonist therapy and who are being managed by one or more of the four activities in the Activity Description; AND
3) Patient-centered plan – Documentation that the plan addresses patients' language and communication needs, literacy level, and cognitive and functional limitations.