2018 ACI Transition Measure: Medication Reconciliation

Under the Merit-based Incentive Payment System (MIPS) pathway of the MACRA Quality Payment Program, Advancing Care Information (ACI) is one of the four performance categories that will be considered and weighted for scoring an eligible clinician’s performance under MIPS.

  • In 2018, there are 2 measure set options for submission depending on the Certified EHR Technology (CEHRT) edition a clinician is using:Advancing Care Information Measures
  • Advancing Care Information (ACI) Transition Measures

Depending on the CEHRT Edition, there will be different objectives from which the MIPS eligible clinician may choose to report. This article outlines the measure details and specifications for the 2018 ACI Transition Measure: Medication Reconciliation.

Measure Set

ACI Transition Measures

Objective:

Medication Reconciliation

Measure:

Medication Reconciliation                  

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.

Scoring Information:

  • Required for Base Score : No
  • Percentage of Performance Score : Up to 10%
  • Eligible for Bonus Score: No


Measure Requirements

  • Numerator: The number of transitions of care or referrals in the denominator where medication reconciliations were performed.
  • Denominator: The number of transitions of care or referrals during the performance period for which the MIPS eligible clinician was the recipient of the transition or referral or has never before encountered the patient.

Scoring Requirements

  • This measure is not required to achieve the ACI base score, but may be selected to earn additional performance score credit.
  • To earn performance score credit with this measure under the ACI performance category, a MIPS eligible clinician should meet the numerator requirements for as many denominator eligible patients as the clinician deems appropriate during his or her selected 2018 performance period.

Measure Denominator Requirements

  • Any patient seen during the performance period who is an incoming transition of care or referral and all new patients will count towards the measure denominator.
  • To gain denominator credit within the Practice Fusion EHR, patients must have at least one signed encounter note with a date of service from within the performance period and an encounter type of Office Visit, Home Visit, Nursing Home Visit, or Telemedicine Visit.
  • Only the MIPS eligible clinician who signs the note receives credit. 
  • For information on meeting the requirements of this measure in Practice Fusion, see the Practice Fusion Suggested Workflow section below.

Measure Numerator Requirements: Practice Fusion Suggested Workflow

Practice Fusion suggests the following workflow to help ensure that you meet the numerator requirements for this measure within the Practice Fusion EHR.

  1. Determine whether the patient is a new patient or an incoming transition of care (e.g. referred from another provider, transitioned from another clinical facility, etc.).

    1. New patients are defined as patients with no prior signed chart notes with the MIPS eligible clinician. You do not need to follow Step 2 for new patients.

  2. If the patient is an incoming transition of care from another provider or clinical facility, indicate this by checking the "Transition of Care - incoming" box under Quality of Care in the encounter note.

  3. Reconcile all appropriate medications for the patient.

    1. Medication reconciliation is considered the process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency, and route, by comparing the medical record to an external list of medications obtained from a patient, hospital or other provider. (Learn more about medication reconciliation from CMS)

4. Once medication reconciliation is complete, check the Medication Reconciliation box under Quality of Care in the encounter note.  

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

  • Review the  CMS measure specifications for more information about this measure.
  • For more information on the Merit-based Incentive Payment System (MIPS) program, you can visit Practice Fusion’s Quality Payment Program Center
  • CMS also provides further resources about the Quality Payment Program here.

Quality Payment Program

  1. 2018 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  2. What is the MIPS Dashboard watch list and how do I use it?
  3. How does the MIPS Dashboard work?
  4. 2018 ACI Transition Measure: Medication Reconciliation
  5. 2018 ACI Transition Measure: Electronic Prescribing (eRx)
  6. 2018 ACI Transition Measure: Secure Messaging
  7. 2018 ACI Transition Measure: Security Risk Analysis
  8. 2018 ACI Transition Measure: Health Information Exchange
  9. 2018 ACI Transition Measure: Immunization Registry Reporting
  10. 2018 ACI Transition Measure: Specialized Registry Reporting
  11. 2018 ACI Transition Measure: Syndromic Surveillance Reporting
  12. 2018 ACI Transitional Measure: View, Download, or Transmit (VDT)
  13. 2018 ACI Transition Measure: Provide Patient Access
  14. 2018 ACI Transition Measure: Patient-Specific Education
  15. 2017 Quality Payment Program: What is the Merit-Based Incentive Payment System (MIPS)
  16. How do I report my 2017 MIPS data to CMS using the Practice Fusion QCDR?
  17. What is the Advancing Care Information (ACI) Performance Category for MIPS and how is it scored?
  18. 2017 ACI Transition Measure: Security Risk Analysis
  19. 2017 ACI Transition Measure: Electronic Prescribing (eRx)
  20. 2017 ACI Transition Measure: Provide Patient Access
  21. 2017 ACI Transition Measure: Health Information Exchange
  22. 2017 ACI Transition Measure: View, Download, or Transmit (VDT)
  23. 2017 ACI Transition Measure: Patient-Specific Education
  24. 2017 ACI Transition Measure: Secure Messaging
  25. 2017 ACI Transition Measure: Medication Reconciliation
  26. 2017 ACI Transition Measure: Immunization Registry Reporting
  27. 2017 ACI Bonus Measure: Syndromic Surveillance Reporting
  28. 2017 ACI Bonus Measure: Specialized Registry Reporting
  29. What is the Improvement Activities Performance Category for MIPS?
  30. What are the Quality performance category reporting requirements for MIPS?
  31. What is the difference between the two Advancing Care Information measure sets available in 2017?
  32. Advanced APM: What is Comprehensive Primary Care Plus (CPC+)?
  33. Which Improvement Activities Qualify for the Advancing Care Information (ACI) Bonus Score in 2017?
  34. How is the MIPS Final Score Calculated?
  35. MIPS for Small, Rural and Underserved Practices
  36. How do I contact CMS about the Quality Payment Program?
  37. What is the Practice Fusion QCDR?
  38. How do I indicate interest in the Practice Fusion QCDR and get my MIPS estimated scores?
  39. Chronic Care Management FAQs
  40. How do I export a JSON file for 2017 MIPS reporting?

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