Promoting Interoperability 2018 Objectives (formerly ACI)

Promoting Interoperability Objectives (formerly ACI)

Base Score Measures (50 Points)

  • * Protect Health Information - Security Risk Analysis
  • * Electronic Prescribing - E-Prescribing & Formulary Comparison
  • * Provide Electronic Access - Provide Patient Access to Health Information within 4 days
  • * Health Information Exchange - Send a Summary of Care
  • * Health Information Exchange - Request/Accept Summary of Care

You must complete all 5 base score measures to receive 50 points. Completing some of the measures will NOT earn you partial credit. Failure to complete a security risk assessment will yield 0 points for the PI category. You only need to have 1 in the numerator for Electronic Prescribing, Provide Patient Access, and Health Information Exchange to receive credit as based score measures.

Performance Score Measures (Earn up to 90 Points):

  • * Public Health and Clinical Data Registry Reporting = 0 or 10 points
  • * Provide Patient Access to Health Information within 4 days = 10 points
  • * Patient-Specific Education = 10 points
  • * View, Download and Transmit (VDT) or API access = 10 points
  • * Secure Messaging = 10 points
  • * Patient-Generated Health Data = 10 points
  • * Send a Summary of Care = 10 points
  • * Request/Accept Summary of Care = 10 points
  • * Clinical Information Reconciliation = 10 points

You must complete all base score measures in order to earn any additional credit, up to 90 points, for the performance scored measures. Select the measures that best suit your practice.

Bonus Points (Earn up to 25 points):

  • * Report using the 2018 Objective and Measures (2015 Edition CEHRT ) exclusively = 10 points
  • * Using certain activities (PI Bonus) in the Improvement Activities category = 10 points
  • * Public Health and Clinical Data Registry Reporting not reported in Performance Score section = 0 to 5 points

You must complete all base score measures in order to earn any additional bonus points (up to 25 points).

Promoting Interoperability Hardship Exceptions

If you’re participating in MIPS during the 2018 performance year as an individual, group, or virtual group—or participating in a MIPS Alternative Payment Model (APM)—you can submit a Quality Payment Program Hardship Exception Application for the PI performance category, citing one of the following specified reasons for review and approval.

  • * MIPS-eligible clinicians in small practices (new for 2018)
  • * MIPS-eligible clinicians using decertified EHR technology (new for 2018)
  • * Insufficient Internet connectivity
  • * Extreme and uncontrollable circumstances
  • * Lack of control over the availability of certified electronic health record technology (CEHRT)

An approved Quality Payment Program Hardship Exception will:

  • * Reweight your PI performance category score to 0 percent of the final score.
  • * Reallocate the 25 percent weighting of the PI performance category to the Quality performance category.

Please note that simply not using CEHRT does not qualify you for reweighting of your PI performance category.

You must submit a hardship exception application by December 31, 2018 for CMS to reweight the PI performance category to 0 percent. The PI Hardship Application can be completed at: https://cmsqualitysupport.service-now.com/exception_application.do

Some clinicians who participate in MIPS are granted Special Status and will be automatically reweighted if they choose not to report on PI measures. Special Status clinicians do NOT need to submit a Quality Payment Program hardship exception application.

Special Status clinicians are identified as: Hospital-based clinicians, Non-patient Facing clinicians, NP, PA, Clinical Nurse Specialist, Certified Registered Nurse Anesthetists and Ambulatory Surgical Center (ASC) based clinicians.

View the objectives/measures specification facts, including how to achieve within ChartMaker Medical Suite, below:


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