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.
ACI Transition Measures
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.
- 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.
- 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.
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.).
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.
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.
Reconcile all appropriate medications for the patient.
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.
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.