Advancing Care Information ( EHR)
OPTIONS FOR ADVANCING CARE INFORMATION REPORTING USING CERTIFIED EHR TECHNOLOGY
In 2017, there are two measure set options for reporting:
• Advancing Care Information Objectives and Measures
• 2017 Advancing Care Information Transition Objectives and Measures (This option for EBIO-METRONICS EMR )
The option you’ll use to send in data is based on your Certified EHR Technology edition.
MIPS eligible clinicians can report the Advancing Care Information objectives and measures if they have:
• Technology certified to the 2015 Edition; or
• A combination of technologies from the 2014 and 2015 Editions that support these measures
In 2017, MIPS eligible clinicians can alternatively report the 2017 Advancing Care Information transition objectives and measures if they have:
• Technology certified to the 2015 Edition; or
• Technology certified to the 2014 Edition; or
• A combination of technologies certified to the 2014 and 2015 Editions
Lets talk about measures & scores;
MEASURES SUMMARY:
Advancing care information objectives & measures (15 measures)
- Clinical Data Registry Reporting
- Clinical Information Reconciliation
- e-Prescribing
- Electronic Case Reporting
- Immunization Registry Reporting
- Patient-Generated Health Data
- Patient-Specific Education
- Provide Patient Access
- Public Health Registry Reporting
- Request/Accept Summary of Care
- Secure Messaging
- Security Risk Analysis
- Send a Summary of Care
- Syndromic Surveillance Reporting
- View, Download and Transmit (VDT)
2017 Advancing care information Transition Objectives & Measures (11 Measures)
- e-Prescribing
- Health Information Exchange
- Immunization Registry Reporting
- Medication Reconciliation
- Patient-Specific Education
- Provide Patient Access
- Secure Messaging
- Security Risk Analysis
- Specialized Registry Reporting
- Syndromic Surveillance Reporting
- View, Download, or Transmit (VDT)
FOR DETAILS OF THESE MEASURES, CLICK HERE:
HOW THE BASE SCORE IS CALCULATED?
MIPS eligible clinicians need to fulfill the requirements of all the base score measures in order to receive the 50% base score. If these requirements are not met, they will get a 0 in the overall Advancing Care Information performance category score.
In order to receive the 50% base score, MIPS eligible clinicians must submit a “yes” for the security risk analysis measure, and at least a 1 in the numerator for the numerator/denominator of the remaining measures.
The base score Advancing Care Information measures are:
1. Security Risk Analysis
2. e-Prescribing
3. Provide Patient Access
4. Send a Summary of Care
5. Request/Accept Summary of Care
The base score 2017 Advancing Care Information transition measures are:
1. Security Risk Analysis
2. e-Prescribing
3. Provide Patient Access
4. Health Information Exchange
As explained above, all of the base score requirements must be met in order to receive the 50% base score and be able to receive a score in the Advancing Care Information category. In addition, it is important to note that some of the base score measures can also contribute towards the performance score.
HOW THE PERFORMANCE SCORE IS CALCULATED?
The performance score is calculated by using the numerators and denominators submitted for measures included in the performance score, or for one measure, by the yes or no answer submitted.
The potential total performance score is 90%. For each measure with a numerator/denominator, the percentage score is determined by the performance rate. Most measures are worth a maximum of 10 percentage points, except for two measures reported under the 2017 Transition measures, which are worth up to 20 percentage points.
Performance Rate >0-10 = 1% Performance Rate 11-20 = 2% Performance Rate 21-30 = 3% Performance Rate 31-40 = 4% Performance Rate 41-50 = 5% Performance Rate 51-60 = 6% Performance Rate 61-70 = 7% Performance Rate 71-80 = 8% Performance Rate 81-90 = 9% Performance Rate 91-100 = 10%
Example: If a MIPS eligible clinician submits a numerator and denominator of 85/100 for the PatientSpecific
Education measure, their performance rate would be 85%, and they would earn 9 out of 10
percentage points for that measure.
The only performance score measure that is yes/no is the Immunization Registry Reporting measure.
MIPS eligible clinicians in active engagement with a public health agency to submit immunization data
who submit a “yes” for this measure would receive the full 10%.
| Improvement Activity Performance Category Subcategory | Activity Name | Activity | Improvement Activity Performance Category Weight | Related Advancing Care Information Measure(s) |
| Expanded Practice Access | Provide 24/7 access to eligible clinicians or groups who have real-time access to patient’s medical record |
Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (for example, eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: Expanded hours in evenings and weekends with access to the patient medical record (for example, coordinate with small practices to provide alternate hour office visits and urgent care); Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as evisits, phone visits, group visits, home visits and alternative locations (for example, senior centers and assisted living centers); and/or Provision of same-day or next day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. |
High |
Provide Patient Access Secure Messaging Send a Summary of Care Request/Accept Summary of Care
|
| Population Management | Anticoagulant management improvements |
MIPS eligible clinicians and groups who prescribe oral Vitamin K antagonist therapy (warfarin) must attest that, in the first performance period, 60 percent or more of their ambulatory care patients receiving warfarin are being managed by one of more of these Improvement Activities: 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 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 INR For patients who demonstrate motivation, competency, and adherence, patients are managed using either a patient self-testing (PST) or patient-self-management (PSM) program. The performance threshold will increase to 75 percent for the second performance period and onward. Clinicians would attest that, 60 percent for first year, or 75 percent for the second year, of their ambulatory care patients receiving |
High |
Provide Patient Access Patient-Specific Education View, Download, Transmit Secure Messaging Patient Generated Health Data or Data from NonClinical Setting Send a Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation Exchange Clinical Decision Support (CEHRT Function Only) |
| Population Management | Glycemic management services |
For outpatient Medicare beneficiaries with diabetes and who are prescribed antidiabetic agents (for example, insulin, sulfonylureas), MIPS eligible clinicians and groups must attest to having: For the first performance period, at least 60 percent of medical records with documentation of an individualized glycemic treatment goal that:
The performance threshold will increase to 75 percent for the second performance period and onward. Clinicians would attest that, 60 percent for first year, or 75 percent for the second year, of their medical records that document individualized glycemic treatment represent patients who are being treated for at least 90 days during the performance period. |
High |
Patient Generated Health Data Clinical Information Reconciliation Clinical Decision Support, CCDS, Family Health History (CEHRT functions only) |
| Population Management | Chronic care and preventative care management for empaneled patients |
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition specific preventive care services; plan of care for chronic conditions; and advance care planning; Use condition-specific pathways for care of chronic conditions (for example, hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; Use panel support tools (registry functionality) to identify services due; Use reminders and outreach (for example, phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. |
Medium |
Provide Patient Access Patient-Specific Education View, Download, Transmit Secure Messaging Patient Generated health Data or Data from NonClinical Setting Send A Summary of Care Request/Accept Summary of care Clinical Information Reconciliation Clinical Decision Support, Family Health History (CEHRT functions only) |
| Population Management | Implementation of methodologies for improvements in longitudinal care management for high risk patients | Provide longitudinal care management to patients at high risk for adverse health outcome or harm that could include one or more of the following: Use a consistent method to assign and adjust global risk status for all empaneled patients to allow risk stratification into actionable risk cohorts. Monitor the risk-stratification method and refine as necessary to improve accuracy of risk status identification; Use a personalized plan of care for patients at high risk for adverse health outcome or harm, integrating patient goals, values and priorities; and/or Use on-site practice-based or shared care managers to proactively monitor and coordinate care for the highest risk cohort of patients. | Medium |
Provide Patient Access Patient-Specific Education Patient Generated Health Data or Data from Nonclinical Settings Send A Summary of Care Request/Accept Summary of Care Clinical information reconciliation Clinical Decision Support, CCDS, Family Health History, Patient List (CEHRT functions only) |
| Population Management | Implementation of episodic care management practice improvements |
Provide episodic care management, including management across transitions and referrals that could include one or more of the following: Routine and timely follow-up to hospitalizations, ED visits and stays in other institutional settings, including symptom and disease management, and medication reconciliation and management; and/or Managing care intensively through new diagnoses, injuries and exacerbations of illness. |
Medium |
Send A Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation |
| Population Management | Implementation of medication management practice improvements |
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or conduct periodic, structured medication reviews. |
Medium |
Clinical Information Reconciliation Clinical Decision Support, Computerized Physician Order Entry Electronic Prescribing (CEHRT functions only) |
| Care Coordination | Implementation or use of specialist reports back to referring clinician or group to close referral loop | Performance of regular practices that include providing specialist reports back to the referring MIPS eligible clinician or group to close the referral loop or where the referring MIPS eligible clinician or group initiates regular inquiries to specialist for specialist reports which could be documented or noted in the CEHRT. | Medium |
Send A Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation |
| Care Coordination | Implementation of documentation improvements for practice/process improvements | Implementation of practices/processes that document care coordination activities (for example, a documented care coordination encounter that tracks all clinical staff involved and communications from date patient is scheduled for outpatient procedure through day of procedure). | Medium |
Secure Messaging Send a Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation |
| Care Coordination | Implementation of practices/processes for developing regular individual care plans | Implementation of practices/processes to develop regularly updated individual care plans for at-risk patients that are shared what the beneficiary or caregiver(s). | Medium |
Provide Patient Access (formerly Patient Access) View, Download, Transmit Secure Messaging Patient Generated Health Data or Data from NonClinical Setting |
| Care Coordination | Practice improvements for bilateral exchange of patient information |
Ensure that there is bilateral exchange of necessary patient information to guide patient care that could include one or more of the following: Participate in a Health Information Exchange if available” and/or Use structured referral notes |
Medium |
Send A Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation |
| Beneficiary Engagement | Use of certified EHR to capture patient reported outcomes | In support of improving patient access, performing additional activities that enable capture of patient reported outcomes (for example, home blood pressure, blood glucose logs, food diaries, atrisk health factors such as tobacco or alcohol use, etc.) or patient activation measures through use of CEHRT, containing this date in a separate queue for clinician recognition and review. | Medium |
Provide Patient Access Patient-specific Education Care Coordination through Patient Engagement |
| Beneficiary Engagement | Engagement of patients through implementation of improvements in patient portal | Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence. | Medium |
Provide Patient Access Patient-specific Education |
| Beneficiary Engagement | Engagement of patients, family and caregivers in developing a plan of care | Engage patients, family and caregivers in developing a plan of care and prioritizing their goals for action, documented in the CEHRT. | Medium |
Provide Patient Access Patient-specific Education View, Download, Transmit (Patient Action) Secure Messaging |
| Safety and Practice Assessment | Use of decision support and standardized treatment protocols | Use decision support and protocols to manage workflow in the team to meet patient needs. | Medium | Clinical Decision Support (CEHRT function only) |
| Achieving Health Equity | Leveraging a QCDR to standardize processes for screening | Participation in a QCDR, demonstrating performance of activities for use of standardized processes for screening for social determinants of health such as food security, employment and housing. Use of supporting tools that can be incorporated in the CEHRT is also suggested. | Medium |
Patient Generated Health Date or Data from a Non-Clinical Setting Public Health and Clinical Data Registry Reporting |
| Integrated Behavioral and Mental Health | Implementation of integrated PCBH model |
Offer integrated behavioral health services to support patients with behavioral health needs, dementia, and poorly controlled chronic conditions that could include one or more of the following: Use evidence-based treatment protocols and treatment to goal where appropriate; Use evidence-based screening and case finding strategies to identify individuals at risk and in need of services; Ensure regular communication and coordinated workflows between eligible clinicians in primary care and behavioral health; Conduct regular case reviews for at-risk or unstable patients and those who are not responding to treatment; Use of a registry or certified health information technology functionality to support active care management and outreach to patients in treatment; and/or Integrate behavioral health and medical care plans and facilitate integration through co-location of services when feasible. |
High |
Provide Patient Access Patient-Specific Education View, Download, Transmit Secure Messaging Patient Generated Health Data or |
| Integrated Behavioral and Mental Health | Electronic Health Record Enhancements for BH data capture | Enhancements to an electronic health record to capture additional data on behavioral health (BH) populations and use that data for additional decision-making purposes (for example, capture of additional BH data results in additional depression screening for at-risk patient not previously identified). | Medium |
Patient Generated Health Data or Data from Nonclinical Setting Send A Summary of Care Request/Accept Summary of Care Clinical Information Reconciliation |
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