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MIPS Improvement Activities:
What to Know for 2026
Improvement Activities are one of the easiest MIPS categories to overlook, mainly because they feel vague. But that doesn’t mean you should ignore them. They’re worth 15% of your final score, and unlike Quality measures that require performance data, IAs are basically “yes, we did this” checkboxes. This category is one of the simpler ways to stabilize your score, especially for inpatient teams that don’t have the time or interest to dig through CMS’s definitions every year.
This guide breaks down what Improvement Activities are, what changed for 2026, how they’re scored, and how to choose the options that make sense for the way your practice actually works.
What Are Improvement Activities?
Improvement Activities are specific actions you take to improve your clinical practice, care quality, or patient outcomes. Think of them as CMS rewarding you for doing things you probably should be doing anyway, like care coordination, patient safety initiatives, using clinical decision support tools, etc.
They’re not clinical outcome measures, and they’re not cost measures. They’re essentially CMS asking: Did your practice take meaningful steps to improve how care happens? You’re not measured on results, just on whether you did the activity for at least 90 consecutive days during the year.
IA Categories
CMS groups IAs into several categories. You don’t have to pick from every category, just choose the ones that fit what you’re already doing (or can easily start doing).
Care Coordination: Things like medication reconciliation post-discharge, tracking referrals, or using shared care plans across providers.
Patient Engagement: Patient portals, shared decision-making tools, collecting patient feedback, or providing access to test results.
Population Management: Identifying high-risk patients, chronic disease management programs, or preventive care reminders.
Patient Safety: Using clinical decision support, conducting safety huddles, or implementing antimicrobial stewardship programs.
2026 Category Update: CMS removed the “Achieving Health Equity” subcategory and replaced it with “Advancing Health and Wellness.” It’s the same idea: addressing social determinants of health, health disparities, and preventive care. Now it casts a wider net and is easier for most groups to align with.
What Changed for 2026
CMS made some adjustments to the IA inventory for 2026. If you’ve been reporting IAs consistently, most of these updates are minor, but it’s worth double-checking that your past activities still qualify.
- Added 3 new activities: These include AI safety protocols, oral health integration, and enhanced telehealth workflows. If you’re already doing any of these, document it.
- Modified 7 existing activities: Mostly clarification on documentation requirements and eligibility criteria. Check if any of your go-to IAs from last year got updated wording.
- Removed 8 activities: If you reported something last year that’s now gone, you’ll need to pick a replacement.
Subcategory change: The “Achieving Health Equity” subcategory is now “Advancing Health and Wellness.”
Another update: CMS is emphasizing that your IAs should connect to measurable improvements in patient care or workflows. It’s not enough to just say you did something. You need documentation showing you actually implemented it and it made a difference (or at least that you tried).
Who Can Report Improvement Activities
IAs can be reported by:
- Individual clinicians: If you’re reporting MIPS solo, you pick your own activities.
- Groups: Groups report the same set of IAs for all clinicians. You get full credit when at least 50% of your group completes the same activity for at least 90 days.
- Virtual groups: Same rules as regular groups.
- Subgroups (under MVPs): Small and rural practices can form subgroups within a larger organization. This can be strategic if different parts of your practice are doing different improvement work.
- APM entities: If you’re in an Advanced APM, you may still report IAs depending on your participation level.
2026 update: CMS confirmed subgroup reporting continues under MVPs. Small and rural practices still get simplified thresholds, which we’ll cover in the scoring section.
How Improvement Activities Are Scored
The Improvement Activities category is worth 15 percent of your final MIPS score.
Each activity has a point value:
- High-weighted activity: 40 points
- Medium-weighted activity: 20 points
- Maximum score: 40 points gets you full credit in the IA category.
How to hit 40 points:
- Report one high-weighted activity, OR
- Report two medium-weighted activities
Most groups report one high-weighted activity and call it done. It’s the simplest path to full credit.
Special scoring for small, rural, and HPSA practices: If you qualify as a small practice (15 or fewer clinicians), practice in a rural area, or serve a health professional shortage area (HPSA), you only need 20 points to get full credit. That means one medium-weighted activity is enough.
Group reporting: Groups get full credit when at least 50% of clinicians in the group perform the same IA for the required 90 days. If you meet that threshold, the entire group receives the credit.
2026 updates: No major changes to scoring thresholds or weights. CMS kept the 75-point MIPS performance threshold through 2028, so the IA category’s 15% weighting stays consistent.
One clarification for 2026: You can combine multiple IAs if they serve distinct purposes. For example, an AI safety activity paired with a population management activity can both count toward your 40 points, as long as they’re genuinely separate initiatives.
How to Pick the Right Improvement Activities
Picking IAs shouldn’t be complicated. Many practices either choose too many activities or pick ones that don’t align with their day-to-day work. Start with what you’re already doing, then fill gaps if needed.
Map to Existing Workflows
Look at your current processes. Are you already doing medication reconciliation? Using clinical decision support? Tracking referrals? Those might already qualify as IAs. Document them properly and submit.
Consider Your Patient Population
If you see a lot of chronic disease patients, pick IAs related to care coordination or population health management. If you’re in the ED, patient safety or discharge planning activities make sense.
Align with Your MVP (if applicable)
If you’re reporting under a MIPS Value Pathway, choose IAs that complement your MVP’s focus. For example, if you’re in the Heart Failure MVP, activities around care transitions or medication management fit naturally.
Think About Group vs. Individual Reporting
If you’re reporting as a group, you need buy-in from at least half your clinicians. Pick activities that the majority of your team can realistically complete. If you’re reporting individually, you have more flexibility to choose niche activities.
Small Practice Strategy
If you qualify for small practice scoring, you only need one medium-weighted activity. Don’t overthink it. Pick something simple that you’re confident you can document well.
Don't Chase Points
The difference between reporting one high-weighted activity and three medium-weighted activities is zero if you have already hit 40 points. Do what’s easiest to document and move on.
Improvement Activities are one of the more manageable parts of MIPS, especially for inpatient providers who are already stretched thin with Quality and PI reporting. The key is picking activities that align with what your practice already does, documenting them properly, and submitting on time.
Stay Organized with Claimocity
Most IAs come down to three things: better visibility into what your team is doing, stronger care coordination, and documentation that holds up under audit. Claimocity handles all three.
Whether you need to track 90-day periods, monitor workflow changes, or align your IA choices with your broader reporting strategy, the platform helps keep everything organized in one place. No more digging for screenshots or scrambling for documentation. You stay organized, on schedule, and far less likely to lose points over avoidable gaps.
Want to take the pressure off reporting? Book a demo, and we’ll show you how it works.
