2017 ACI Transition Measure: Electronic Prescribing (eRx)

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.

Objective:

Electronic Prescribing

Measure:

Electronic Prescribing            
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology (CEHRT).

Scoring Information:

  • Required for Base Score (50%): Yes
  • Percentage of Performance Score (up to 90%): None
  • No bonus points available

Reporting Requirements

  • 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.

*Note: When reporting on the e-Prescribing measure, an eligible clinician will have the option to include or not include controlled substances that can be electronically prescribed in the denominator for the e-Prescribing measure calculation.

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.

  1. From the patient encounter, use the Plan section to add a medication.
  2. Use the fly-out pane to the left of the Plan to select a medication from the Frequent, Previous, or Record tab.
  3. Once added, click on the name of the newly added medication to order the prescription.
  4. 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)?

Data Validation
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.  

More information

Quality Payment Program

  1. Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  2. What is the Advancing Care Information (ACI) Performance Category for MIPS and how is it scored?
  3. 2017 ACI Transition Measure: Security Risk Analysis
  4. 2017 ACI Transition Measure: Electronic Prescribing (eRx)
  5. 2017 ACI Transition Measure: Provide Patient Access
  6. 2017 ACI Transition Measure: Health Information Exchange
  7. 2017 ACI Transition Measure: View, Download, or Transmit (VDT)
  8. 2017 ACI Transition Measure: Patient-Specific Education
  9. 2017 ACI Transition Measure: Secure Messaging
  10. 2017 ACI Transition Measure: Medication Reconciliation
  11. 2017 ACI Transition Measure: Immunization Registry Reporting
  12. 2017 ACI Bonus Measure: Syndromic Surveillance Reporting
  13. 2017 ACI Bonus Measure: Specialized Registry Reporting
  14. What is the Improvement Activities Performance Category for MIPS?
  15. What are the Quality performance category reporting requirements for MIPS?
  16. What is the difference between the two Advancing Care Information measure sets available in 2017?
  17. Advanced APM: What is Comprehensive Primary Care Plus (CPC+)?
  18. Which Improvement Activities Qualify for the Advancing Care Information (ACI) Bonus Score in 2017?
  19. What is the MIPS Dashboard watch list and how do I use it?
  20. How does the MIPS Dashboard work?
  21. How is the MIPS Final Score Calculated?
  22. MIPS for Small, Rural and Underserved Practices
  23. How do I contact CMS about the Quality Payment Program?
  24. What is the Practice Fusion QCDR?
  25. How do I indicate interest in the Practice Fusion QCDR and get my MIPS estimated scores?
  26. Chronic Care Management FAQs

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