Transform HIV Prevention in Your Practice With a New Quality Initiative

The Ending the HIV Epidemic (EHE) initiative, launched by the US Department of Health and Human Services in 2019, aims to reduce new HIV infections by 75% by 2025, and 90% by 2030. Despite ongoing efforts, significant advancements in HIV prevention remain critically necessary. For instance, only 3% of federal funding has been dedicated to prevention, and nearly 13% of Americans living with HIV are unaware of their status. While preexposure prophylaxis (PrEP) reduces the risk of acquiring HIV from sex by nearly 99%, only 30% of individuals for which PrEP is recommended received a prescription in 2021.

A strategic shift is necessary to energize our national approach to HIV prevention, with clinicians at the forefront, fueled by new tactics from the Centers for Medicare & Medicaid Services (CMS).

Empower Your Practice: Elevate HIV Prevention and Maximize Merit-Based Incentive Payment System Performance

Clinicians play a crucial role in advancing HIV prevention through practice-level strategies. Now, CMS is offering a clear path for clinicians to do so under their Merit-based Incentive Payment System (MIPS). This program adjusts Medicare clinician payment to performance across four categories: quality, cost, improvement activities, and promoting interoperability. MIPS applies to Medicare clinicians who are not part of an alternative payment model, such as a Medicare Accountable Care Organization or bundled payment arrangement.

Until recently, there was a noticeable gap within MIPS for HIV prevention. However, in 2024, CMS introduced a new HIV Prevention Improvement Activity, offering an evidence-based blueprint for clinicians to improve quality of care in HIV prevention in alignment with Centers for Disease Control and Prevention clinical guidelines and EHE priorities.

The HIV Prevention Improvement Activity allows clinicians to incorporate at least one of three tactics: (1) implement electronic health record prompts or clinical decision support tools to increase HIV screening, (2) participate in at least one HIV prevention educational opportunity, and/or (3) assess/refine current policies for HIV prevention screening (Figure).    

The HIV Prevention Improvement Activity is available now for clinicians to select, report, and implement into practice for MIPS credit, and it can supercharge your HIV prevention efforts.

Discover More: Dive into the Details of the Improvement Activity

For clinicians, the call to action is clear. The MIPS HIV Prevention Improvement Activity provides an opportunity to enhance quality of care while also fulfilling the requirements for MIPS reporting. So, what should you do next?

1. Educate Yourself and Your Team: Review the components of the HIV Prevention Improvement Activity to understand the requirements to implement, validate, and report.

2. Integrate the HIV Prevention Improvement Activity into Your Practice: Evaluate your current initiatives against the Improvement Activity requirements, determine whether your practice is currently implementing any of the three specified activities, and if not, develop a strategy for incorporating one of these activities into your practice.

3. Spread the Word: Promote the use of the HIV Prevention Improvement Activity among your peers and within your professional networks to amplify its impact.

To learn more about MIPS improvement activities and opportunities to enhance HIV prevention in your practice, view the CMS Improvement Activities Quick Start Guide.

CMS’s introduction of the MIPS HIV Prevention Improvement Activity marks a pivot in ongoing efforts to prevent the transmission of HIV. By embracing this opportunity, you can play a crucial role in advancing HIV prevention, reducing disparities, and, ultimately, saving lives. Let’s join forces to make HIV prevention a priority in our practices and communities.

For more information regarding the HIV Prevention Improvement Activity, reach out to Veronica Ellis (vellis@realchemistry.com).

About the Quality Outlook Commentary Series

Breakthrough treatments in cancer care, including precision therapies tailored to specific patient factors, are driving rapid changes in the definitions of oncology quality and value. Efforts to implement value-based care models in oncology must meet the demands of evolving science, new best care practices, and shifting patient priorities. Quality measures must be up-to-date and relevant. Payment models must recognize the challenges and costs of managing complex patient populations with diverse needs. In this JCP blog series, Quality Outlook, Real Chemistry will explore key issues in oncology quality and value through posts focused on measurement, value-based payment, and quality improvement.

Veronica Ellis

Veronica Ellis is a Manager at Real Chemistry with extensive experience in health policy and quality landscape analysis spanning a range of therapeutic areas, disease states, and products. Her recent work has involved strategizing on health system and payer engagement tactics for clients through evaluating metrics of health system quality performance and refining value propositions. With a foundation in public health, Veronica provides strategic direction and support for clients to achieve success in the value-based care environment.

Sara Valek

Sara Valek, MPH, a director at Real Chemistry, is a seasoned public health specialist with over a decade of experience across the public and private sector, specializing in HIV/infectious disease initiatives and cancer prevention and control. Sara excels in stakeholder engagement strategies and qualitative research, with a dedication to highlighting the patient voice. As part of Real Chemistry’s Market Access division, Sara helps clients translate complex ideas into actionable insights to generate value around life-saving therapies, promote access to care, and improve patient outcomes.

Kaitlyn Esselman

Kaitlyn Esselman, MHS, is a vice president of Market Access Strategy at Real Chemistry. With an extensive background in public health, policy, and data analytics, Kaitlyn leads client engagements that focus on developing innovative solutions to ensure that patients receive timely access to appropriate products and therapies. She is well-versed in helping clients articulate the value of their therapeutics to payers and health systems through compelling value propositions, developing access strategies, and conducting health economics and outcomes research.

Tom Valuck

Tom Valuck, MD, JD, is a partner at Real Chemistry. He is a thought leader on health care system transformation and helps lead the firm’s focus on achieving better health and health care outcomes at a lower cost. Tom’s work at Real Chemistry includes facilitating the exploration of next-generation measurement and accountability models for health care delivery systems. He also helps clients develop strategies to achieve success within the value-based marketplace.