The Malnutrition Care Score quality measure is available for 2025 hospital reporting.
Food insecurity and malnutrition are interconnected conditions that impair patient health, worsen outcomes, exacerbate chronic health concerns, and burden our healthcare system.
The Centers for Medicare & Medicaid Services (CMS) recognized the importance of identifying and addressing food insecurity and nutrition risk as a key strategy for improving health outcomes and advancing health equity by including a food insecurity and nutrition risk improvement activity in the Improvement Activities (IA) category of the Merit-Based Incentive Payment System (MIPS). The activity has also been adopted in several MIPS value pathways (MVPs).
Improvement Activities are one of four categories required by the Merit-Based Incentive Payment System (MIPS) and provide opportunities for participating clinicians to implement activities that improve clinical practice, care delivery, and outcomes. IAs are included in 2 reporting options within MIPS:
An MQii-developed IA focused on food insecurity and nutrition risk was implemented and made available for reporting in traditional MIPS starting on January 1, 2022. Activity IA_AHE_9 is titled, “Implement Food Insecurity and Nutrition Risk Identification and Treatment Protocols,” is classified as a medium weight activity, and is categorized under the “Achieving Health Equity” subcategory. Beginning in 2024, the IA is also available for reporting in 7 MVPs:
The IA is intended to facilitate identification and provision of appropriate support to patients with or at risk for food insecurity and patients with or at risk for poor nutritional status (poor nutritional status is sometimes called clinical malnutrition or undernutrition and applies to people who are overweight as well as underweight.)
CMS has indicated that actions to implement the IA may include—but are not limited to—use of Malnutrition Quality Improvement Initiative (MQii) or other quality improvement resources and standardized screening tools to assess and improve current food insecurity and nutrition risk screening and care practices. A full description of the IA can be found on the Improvement Activity repository on the Quality Payment Program website.
To implement this IA in your practice, follow these three basic steps and recommended workflow for a patient visit:
After answering these questions, work with your practice leaders to identify optimal documentation, workflow, tools, and community referral pathways and resources to use. Our webpage about food insecurity and nutrition risk shares many potential resources to help address these issues.
The screening and intervention workflows below outline the recommended steps for screening for food insecurity and/or nutrition risk and providing resources and appropriate care for those at risk. More details on the available resources are provided on our webpage about food insecurity and nutrition risk.
Overview of MIPS Improvement Activities
Getting Credit for Pursuing this Food Insecurity and Nutrition Risk IA
These materials were developed by the Malnutrition Quality Improvement Initiative (MQii),
a project of the Academy of Nutrition and Dietetics, Avalere Health, and other stakeholders who
provided guidance and expertise through a collaborative partnership. Support provided by Abbott.
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