Advancing Care Information Requirements
The Advancing Care Information (ACI) category of MIPS replaces the Medicare EHR Incentive Program (Meaningful Use) program and is intended to promote patient engagement and the electronic exchange of information using certified EHR technology. The ACI category is worth 25% of your MIPS Final Score in 2017.
Determine which participation method for MIPS you wish to use in 2017, and then complete the requirements associated with that participation method as outlined below.
- MIPS Test Pace Participation. Submit data for the four required base score measures from the 2017 ACI Transition Measure set. If you choose to report the ACI category for Test Pace participation, yes/no measures must be reported as a “yes” and any measure that has a numerator and denominator must have a numerator of at least 1 and a denominator of at least 1 in order to receive credit for this category.
- MIPS Partial Year Participation. Submit 90 days of 2017 data to Medicare for the four ACI Transition Measure Set required base score measures and at least one additional performance score measure from the 2017 ACI Transition Measure set before March 31, 2018. Reported measures must have at least 1 in the denominator and 1 in the numerator and yes/no measures must be reported as a “yes” in order to receive credit for this category.
- MIPS Full Year Participation. Submit a full year of 2017 data (January 1, 2017 through December 31, 2017) to Medicare for the four ACI Transition Measure Set base score measures and at least one additional performance score measure from the 2017 ACI Transition Measure set before March 31, 2018. Reported measures must have at least 1 in the denominator and 1 in the numerator and yes/no measures must be reported as a “yes” in order to receive credit for this category.
ACI Transition Measures
Practice Fusion will support the 2017 ACI Transition Measure Set, which is available for eligible clinicians and groups using 2014 Edition certified EHR technology (or a combination of 2014 and 2015 Edition certified EHR technology) to meet ACI Category requirements during the 2017 performance period. The measures included in the 2017 ACI Transition measure set are listed below:
- Security Risk Analysis. Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by CEHRT in accordance with requirements in 45 CFR 164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician’s risk management process.
- e-Prescribing (eRx): At least one permissible prescription written by the MIPS eligible clinician must be queried for a drug formulary and transmitted electronically using certified EHR technology.
- Provide Patient Access: At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician’s discretion to withhold certain information.
- Health Information Exchange: The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
- Secure Messaging: For at least one patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative), during the performance period.
- View, Download, Transmit: At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
- Medication Reconciliation: The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
- Patient-Specific Education: The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
- Immunization Registry Reporting: The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
- Syndromic Surveillance Reporting: The MIPS eligible clinician is in active engagement with a public health agency to submit syndromic surveillance data.
- Specialized Registry Reporting: The MIPS eligible clinician is in active engagement to submit data to specialized registry.
ACI Category Scoring for 2017
The ACI category is worth 25% of your MIPS Final Score in 2017. The category is scored based on satisfaction of base, performance and bonus requirements. The ACI Performance Category has the potential for over 100% as a total score due to the available bonus points, but the contribution to the MIPS Composite Performance Score is capped at 100%. It is possible to earn the full 100% ACI category score without completing any bonus activities.
ACI Category Flexibility
CMS will automatically reweight the ACI performance category to zero for hospital-based MIPS eligible clinicians (75% or more of Medicare services performed in the inpatient, on campus outpatient department or emergency department), clinicians who lack face- to-face patient interactions, nurse practitioners, physician assistants, certified registered nurse anesthetists and clinical nurse specialists. CMS will reweight the category to 0 and assign the 25% to the quality performance category to offset the difference in the MIPS Final Score, although it is important to note that if clinicians do choose to report data for the ACI category, CMS will be score the category as normal.
Base Score + Performance Score + Bonus Score = ACI Category Total Score
|Measure Name||Required for Base Score?||Performance Score Weight|
|Security Risk Analysis||Yes||0 (yes/no measure)|
|Health Information Exchange||Yes||20%|
|Provide Patient Access||Yes||20%|
|View, Download, Transmit||No||10%|
|Immunization Registry Reporting||No||0 or 10% (yes/no measure)|
|Specialized Registry Reporting||No||No (Bonus measure)|
|Syndromic Surveillance Reporting||No||No (Bonus measure)|
Base Score Requirements: Report data to CMS for all four Base Score measures. Reported measures must have at least 1 in the denominator and 1 in the numerator and yes/no measures must be reported as a “yes” in order to receive Base Score credit. Failure to meet the base score measure reporting requirements will result in a base score of zero, which will prevent the clinician from earning an additional performance score and result in an ACI performance score of zero.
Performance Score Requirements : Report data to CMS for one or more of the Performance Score measures, which are measures that have a weighted value. The percentage listed next to each measure indicates how much that measure can contribute to the total performance score, based on the measure rate (the numerator divided by the denominator). The exception to this is the Immunization Registry Reporting measure, which is a yes/no Performance Score measure. The higher a clinician’s performance rate on these measures, the higher their ACI Category score will be. The Performance Score can contribute up to 90% of the total ACI Category score.
Bonus Score Requirements: The ACI bonus score can be worth up to 15% of the total ACI score, and includes the following:
- Report to one or more additional public health and clinical data registries beyond the Immunization Registry Reporting measure (5% bonus).
- Use certified EHR technology to complete certain improvement activities in the Improvement Activities Performance Category (10% bonus).
Centers for Medicare and Medicaid Services. Quality Payment Program website. Accessed February 2017.
What is the Quality Payment Program?
Quality Payment Program is the name given to the new Medicare value-based reimbursement system. The program has two tracks for participation: MIPS and APM
What are APMs?
MACRA allows providers who take further steps towards transforming healthcare to be exempt from MIPS and participate in Advanced Alternative Payment Models (APMs).
How to prepare
Individual eligible providers can prepare to meet all MIPS measures and be ready to avoid penalties and earn bonuses on January 1, 2017.