What is the Promoting Interoperability (PI) performance category in MIPS?
The Promoting Interoperability (PI, formerly Advancing Care Information) performance category promotes:
- Patient engagement
- The electronic exchange of health information using certified electronic health record technology (CEHRT).
The PI performance category replaced the Medicare EHR Incentive Program for eligible professionals. It gives you more flexibility when you pick measures than the Medicare EHR Incentive Program did. In 2018, this performance category is worth 25% of your MIPS Final Score.
For the 2018 performance year, Practice Fusion will support the 2018 PI Transition Measure Set, which is available for eligible clinicians using a combination of 2014 Edition and 2015 Edition Certified EHR technology (CEHRT).
How is the Promoting Interoperability performance category scored in 2018?
In 2018, the PI category is worth 25% of a clinician’s MIPS Final Score and is based on the satisfaction of base score, performance score and bonus score requirements, all of which are weighted differently in terms of their contribution to the Promoting Interoperability performance category final score. The PI performance category has the potential for over 100% as a total score, but the contribution to the MIPS final score is capped at 100%. For example, under the current scoring methodology, it is possible to earn the maximum PI performance category score without completing any bonus activities.
The Promoting Interoperability score is the sum of these three scores:
- Required Base Score (worth 50% of the category score)
- Optional Performance Score (worth up to 90% of the category score)
- Optional Bonus Score (worth up to 25% of the category score)
Continue reviewing this article for additional information on the three score types associated with the Promoting Interoperability performance category.
How is the Promoting Interoperability Base Score calculated in 2018?
To achieve the PI base score, Practice Fusion providers who are MIPS eligible clinicians will need to satisfy the four required base score measures included in the 2018 PI Transition Measure Set:
Security Risk Analysis: Conduct or review a security risk analysis in accordance with the requirements set forth 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 the requirements set forth in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), implement security updates as necessary, and correct identified security deficiencies as part of the MIPS eligible clinician’s risk management process.
Electronic Prescribing: At least one permissible prescription written by the MIPS eligible clinician must be queried for a drug formulary and transmitted electronically using CEHRT.
Exclusion: Any MIPS eligible clinician who writes fewer than 100 permissible prescriptions during the performance period
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 that summary to a receiving health care clinician for at least one transition of care or referral.
Exclusion: Any MIPS eligible clinician who transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.
In order to receive base score credit, all 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.” Alternatively, if you qualify for an exclusion for the Electronic Prescribing or Health Information Exchange measures, you can attest to the exclusion and still meet the Base Score requirements as long as the data in the EHR indicates eligibility.
Failure to meet the base score measure reporting requirements will result in a base score of zero. Furthermore, this will prevent the clinician from earning any additional performance score credit and will result in a PI performance category score of zero.
How is the Promoting Interoperability Performance Score calculated in 2018?
CMS calculates the performance score using the numerators and denominators you submit for measures included in the performance score. There’s one measure that uses the “yes” or “no” as the 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 included in the 2018 Transition measures, which are worth up to 20 percentage points.
To earn points towards the PI Performance Score, a MIPS eligible clinician must satisfy at least one additional PI performance score measure during his or her performance period. This means that at least one performance score measure must have a numerator greater than 1 and clinicians must submit a numerator/denominator or Yes/No for each PI performance score measure they report.
The following measures in the 2018 PI Transition Measure Set can contribute to the PI Performance Score:
- Provide Patient Access (up to 20%): To earn performance score credit for this measure, the clinician may complete the base score numerator requirements as detailed above for as many additional denominator eligible patients as the clinician deems appropriate during their selected 2017 performance period.
- View, Download or Transmit (VDT) (up to 10%): 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.
- Health Information Exchange (up to 20%): To earn performance score credit for this measure, the clinician may complete the base score numerator requirements as detailed above for as many additional denominator eligible patients as the clinician deems appropriate during their selected 2018 performance period.
- Secure Messaging (up to 10%): 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.
- Medication Reconciliation (up to 10%): 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 (up to 10%): 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 during the performance period.
- Immunization Registry Reporting (0 or 10%, Yes/No measure): The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data generated using CEHRT.
Measures will earn points towards the PI Performance Score using a decile scoring methodology. The table below show how a measure’s performance rate is translated into points that contribute to the total score.
Performance Rates and contributing percentage points for each measure worth up to 10%
Performance Rates and contributing percentage points for each measure worth up to 20%
Performance Rate >0-10% = 1% point
Performance Rate 11-20% = 2% points
Performance Rate 21-30% = 3% points
Performance Rate 31-40% = 4% points
Performance Rate 41-50% = 5%points
Performance Rate 51-60% = 6% points
Performance Rate 61-70% = 7% points
Performance Rate 71-80% = 8% points
Performance Rate 81-90% = 9% points
Performance Rate 91-100% = 10% points
Performance Rate >0-10% = 2% points
Performance Rate 11-20% = 4% points
Performance Rate 21-30% = 6% points
Performance Rate 31-40% = 8% points
Performance Rate 41-50% = 10% points
Performance Rate 51-60% = 12% points
Performance Rate 61-70% = 14% points
Performance Rate 71-80% = 16% points
Performance Rate 81-90% = 18% points
Performance Rate 91-100% = 20% points
As an example, if a clinician were to select the 2018 PI Transition Measure Patient-Specific Education for a performance measure (worth up to 10% of the total Performance Score) and submit a numerator/denominator of 85/100, then that clinician would achieve an 85% performance rate for that measure, placing them into the Performance Rate 81-90 bracket with the potential to gain a 9% PI Performance Score on top of the PI Base Score.
How is the Promoting Interoperability Bonus Score calculated in 2018?
Practice Fusion EHR users can earn bonus percentage points in the Promoting Interoperability performance category in two ways:
- Reporting “yes” for 1 or more additional public health agencies or clinical data registries (i.e specialized registry or syndromic surveillance) beyond the one identified for the performance score measure results in a 5% bonus.
- Reporting “yes” to the completion of at least 1 of the specified Improvement Activities using Certified EHR Technology (CEHRT) will result in a 10% bonus and submitting that activity for the Improvement Activity performance category. A full list of the Improvement Activities that are eligible for this bonus can be found here.
Practice Fusion makes reporting for MIPS easy
Practice Fusion’s MIPS Dashboard is an easy-to-manage tool that allows you to track your progress for MIPS. You can use the MIPS Dashboard and its intuitive watch list functionality to monitor your performance on the MIPS measures and activities you may want to report, with no limit to the number of items you can track throughout the year.
Practice Fusion has again been recognized by CMS as a Qualified Clinical Data Registry (QCDR) for the 2018 performance year, which means Practice Fusion EHR customers can efficiently track and report MIPS data to CMS directly through the EHR. More information about participating in the Practice Fusion QCDR will be available in Fall 2018.
- For more information on the 2018 MIPS Promoting Interoperability Performance Category, including helpful FAQs from CMS, click here.
- Further details regarding the MIPS program requirements can be found here.
- CMS also provides further resources about the Quality Payment Program here.