Under the Merit-based Incentive Payment System (MIPS) pathway of the MACRA Quality Payment Program, the Advancing Care Information (ACI) category replaces the Medicare EHR Incentive Program (Meaningful Use). ACI is one of the three performance categories that will be considered and weighted for scoring an eligible clinician’s performance under MIPS (four categories will be included starting in 2018). A clinician’s score for the Electronic Prescribing measure is dependent on the clinician meeting the measure’s base score requirements. For more information on ACI scoring methodology, please click here.
- Numerator: The number of prescriptions in the denominator generated, queried for a drug formulary, and transmitted electronically using CEHRT.
- Denominator: A) Number of prescriptions written for drugs requiring a prescription in order to be dispensed other than controlled substances during the performance period; or B) number of prescriptions written for drugs requiring a prescription in order to be dispensed during the performance period.
- Measure Exclusion: Any MIPS eligible clinician who writes fewer than 100 permissible prescriptions during the performance period. A MIPS eligible clinician may claim this exclusion if the exclusion criteria are met, but is not required to do so and may report on the measure if he or she chooses.
Additional Measure Information
To earn base score credit for this measure, a MIPS eligible clinician will be required to meet the numerator requirements for at least one denominator eligible prescription. Prescriptions are added to the denominator when they are recorded, printed, or e-prescribed in the patient’s chart. Please note that credit will be calculated for each patient with a signed note that has a date of service during your selected performance period and an encounter types of Office Visit, Home Visit, Nursing Home Visit, or Telemedicine Visit. Only the MIPS eligible clinician who signs the note will receive measure credit. For information on earning numerator credit for this measure, see the Practice Fusion Suggested Workflow section below.
A drug formulary is a list of preferred medications based on a patient's insurance and allows providers to save prescription costs for patients. Practice Fusion automatically enables drug formulary query functionality for all clinicians who are enabled for e-prescribing through the Practice Fusion EHR.
Practice Fusion Suggested Workflow
Practice Fusion suggests the following workflow to ensure that you earn numerator credit for this measure within the Practice Fusion EHR.
- From the patient encounter, use the Plan section to add a medication.
- Use the fly-out pane to the left of the Plan to select a medication from the Frequent, Previous, or Record tab.
- Once added, click on the name of the newly added medication to order the prescription.
- Once you have completed the required fields, select the pharmacy you wish to send the order to and click Send eRx.
1. From the encounter, select Record in the Plan section.
2. Choose the Medications tab from the flyout window on the left and select from Frequent, Previous, or Record to associate a medication with the encounter.
3. Once you have chosen a medication on the left-hand side, it will be added to the “Note” portion on the right, under the Medications attached to this encounter section. Click on the name of the newly added medication to order a prescription.
4. Enter the required directions and a start date in the details window and click Order to continue the prescription.
5. Once you have completed all the required fields, review your prescription summary, confirm that your prescription summary is accurate and select a pharmacy to fill the order. Click Send eRx.
For additional instructions, see How do I send an eRx (e-prescription)?
CMS has published guidance to help providers better understand the documentation they should retain around meeting MIPS requirements. CMS calls this guidance "MIPS Data Validation Criteria" because it describes the types of documentation that would validate the data the provider submits to CMS at the end of the performance period. You can learn more about this by reviewing CMS’ MIPS Data Validation Fact Sheet and you can see the specific documentation guidelines applicable to the ACI Transition Measures in CMS’ MIPS Data Validation Criteria for ACI Transition Measures.