Getting the Most out of MIPS Part 2: How to achieve 100% Score in Advancing Care Information Performance Category

In part 1 of this series, we saw how to maximize your score in Quality Performance Category. In this blog, we’ll talk about Advancing care Information and tips for achieving 100% performance in this Category. Advancing Care Information (ACI) is one of the four performance categories for MIPS and accounts for 25% of the Composite MIPS Score. It replaces the Medicare EHR Meaningful use incentive program.

Advancing Care Information will be reweighted as 0 for Hospital based Clinicians, non-patient facing clinicians, NP, PA, CRNAs, and CNS. Clinicians can apply to have their ACI weighted to 0 and the 25% assigned to Quality performance category for the following reasons:

  • Insufficient network connectivity.
  • Extreme and uncontrollable circumstances.
  • Lack of control over the availability of CHERT.

How to achieve 100% Score in Advancing Care Information Performance Category

In 2017, you can choose from 2 measures sets based on your Certified EHR Edition:

  • Advancing Care Information Objectives and Measures if you are using 2015 Edition certified EHR or a combination of 2014 and 2015 Edition certified EHR (Table A)
  • 2017 Advancing Care Information Transition Objectives and Measures if you are using 2014 or 2015 Edition certified EHR or a combination of 2014 and 2015 Edition certified EHR (Table B)

Table A: ACI Transition Objectives and Measures

Table A: ACI Transition Objectives and Measures

Table B: 2017 ACI Transition Objectives and Measures

Table B: 2017 ACI Transition Objectives and Measures

Scoring ACI: ACI score is a combination of Base Score (of 50) + Performance Score (up to 90) and Bonus score (up to 15). Maximum possible score is 155, but it is capped at 100. (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. To meet the base score, you need to attest “Yes” for the security risk analysis measure and report a numerator of at least 1 for the remaining measures required in the base score (See Table A & B). For additional performance measures, you can have up to 10 points each based on your performance rate as shown in  table C, with the exception of immunization registry where you score 10 for submitting to an immunization registry and 0 for not submitting data to the immunization registry. (There is also additional 5% bonus points for reporting to one or more additional public health and clinical data registries beyond the Immunization Registry Reporting measure and 10% bonus for reporting “yes” to completion of at least 1 improvement activities using CEHRT.)

Table C: Performance Score

Table C: Performance Score

 

 

 

 

 

 

 

 

 

 

Participation Option: You can participate as an individual or group. Group means a single TIN with 2 or more NPIs who have reassigned their Medicare billing rights to the TIN. For group submission, you have to aggregate the performance score for all the clinicians in the TIN.

Data Submission: you need to submit data for minimum 90 consecutive days

How can I score 100% in ACI? Obtaining 100% performance score for ACI is not impossible

    • Do you fit into any of the ACI exceptions? Apply with CMS to have you reweighted to 0 on ACI. Otherwise, read on.
    • Find out which version of ONC Edition your EHR is certified for. If your EHR is certified 2014 Edition, you need to report the ACI transition measure set. If your EHR is 2015 Edition or combination of both 2015 and 2014 edition, you can choose either the ACI measure set or the ACI Transition Measure set.
    • Meet the base score – it is mandatory to meet this in order to score anything under ACI. This will fetch 50 points.
      • Perform the security risk analysis
      • Query at least one permissible prescription for drug formulary and send it electronically
      • Provide access to view, download and transmit their health information to at least one patient seen during the performance period
      • Create and electronically send a Summary of Care record for at least one patient referred or transitioned to another care setting during the performance period
      • If submitting the ACI measures, electronically receive and incorporate summary of care for at least one transition of care or referral received
    • Determine your bonus points
      • Do you submit to Public Health Registry other than immunization registry? You get bonus of 5 points.
      • Would you be performing any of the CEHRT applicable improvement activities and utilizing your certified EHR for it? You get a bonus of 10.
    • Determine the performance points needed to achieve 100% ACI score. Based on your bonus points (up to 15), you will need only 35-50 additional points under the performance score.
      • Do you submit to immunization registry? You already have 10 points.
      • From the remaining 8 performance measures, you would need an average of 31%-61% performance rate per measure. Work out your goals for each of the 8 measures and monitor them periodically.
      • Device a checklist which you and your staff can follow for each visit a patient makes to your office:
        • When booking an appointment or checking-in a patient, ask your front desk to verify if the patient has an active patient portal account and provide one if they do not have it and educate them on how to use it.
        • Provide an electronic copy of the visit summary after each visit.
        • Provide relevant education material electronically to the patients.
        • Encourage patients to use the secure message feature of the Patient Portal to communicate with the staff and instruct staff to reply to the messages and send important reminders through the secure messaging.
        • For each patient, you refer out, prefer sending the referral summary through the Direct Message protocol instead of faxing it.
        • For each patient you see for the first time or transition-in to your practice, remember to perform clinical reconciliation.
        • Invest in an EHR (such as iPatientCare) that can provide you alerts for each of the above prior to signing-off a visit note.

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About the Author:

Arnaz Bharucha is the R&D Lead for Quality Improvement and Senior Software Architect with over 17 years of experience in designing and supporting healthcare IT products for Electronic Health Record, Quality Reporting for MIPS, Meaningful Use, PQRS, PCMH, DOQ-IT etc., and professional & institutional medical billing systems. She has shouldered key responsibilities of understanding the US Healthcare industry standards, designing iPatientCare suite of products in compliance with the ONC’s Meaningful Use, designing and implementing interoperability and other healthcare Quality Reporting initiatives requirements. Under her leadership, iPatientCare has been a Qualified Registry for submitting quality measures to CMS since 2014.

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