MACRA Monday: Advancing Care Information Performance Category
MACRA Monday: Advancing Care Information Performance Category October 31, 2016
Every Monday for the next four weeks, we’ll be breaking down the four performance categories that independent practices will be required to report on when the Merit-based Incentive Payment System or MIPS track of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) law goes into effect on January 1, and providing you with tips and strategies on how to succeed during this transition.
With the “Advancing Care Information” performance category for MIPS constituting 25% of reimbursements for providers come 2017, it’s an important category to consider as MACRA nears.
This category refers to EHR usage, as this performance category was designed to replace the requirement to meaningfully use certified EHR technology which was previously measured under the Meaningful Use (MU) program.
What are the requirements?
As we previously mentioned, MACRA participants now have options for how they can participate during the first reporting year. However, for those who are ready for full participation, this performance category calls for reporting on 5 reporting measures, a reduction from the 11 measures that were originally proposed in MACRA’s proposed rule. These simplified measures now include:
1. Security Risk Analysis
2. e-Prescribing
3. Provide Patient Access
4. Send Summary of Care
5. Request/Accept Summary of Care
In addition, practices may choose to submit up to 9 measures to receive additional credit that would make them eligible for a small bonus toward their composite score for this performance category.
Comparing Advancing Care Information Performance Category with Meaningful Use
Though this performance category replaces Meaningful Use — a program that might be familiar to most small or solo practitioners, Advancing Care Information is designed to be a more simplified and flexible version of MU.
| Meaningful Use | Advancing Care Information |
| One-size-fits-all — every objective reported and weighed equally | Customizable — providers can choose which categories to emphasize in their scoring |
| Requires across-the-board levels of achievement of “thresholds,” regardless of practice experience | Flexible. Allows for diverse reporting that matches clinician’s practice and experience |
| Measurement emphasizing process | Measurement emphasizing patient engagement and interoperability |
| Disjointed and redundant with other Medicare reporting programs | Aligned with other Medicare reporting programs. No need to report redundant quality measures |
| No exemptions for reporting |
Exemptions for reporting for clinicians in: Advanced alternative payment models; first year with Medicare; have low Medicare volumes |
How is the scoring determined?
The score for this performance category is calculated by combining together points from a base score, performance score, and any bonus points to create a composite score. In order to receive their base scores, physicians are simply required to provide the numerator/denominator or yes/no for the six objectives we listed earlier.
After determining a base score, physicians can calculate their performance score by selecting the objectives that best fit their practice from the following list of measures:
1. Patient Electronic Access
2. Coordination of Care through Patient Engagement
3. Health Information Exchange
Eventually, the base score, performance score, and if applicable, bonus points can be added together for a total of up to 131 points. If a physician earns 100 points or more, they will receive the full 25 points for the Advancing Care Information category. If a participant earns less than 100 points, then their overall score in MIPS will decline proportionately. Consequently, scoring is or all-or-nothing.
How Elation Supports this Performance Category:
As a certified EHR platform, Elation is well-equipped to support practices participating in MIPS. With the Advancing Care Information category focused on the meaningful use of an EHR system, using a
clinical EHR can help practices participate in required activities such as e-Prescribing, care coordination, and patient engagement
simply and intuitively all within one platform.
At the same time, Elation’s built-in dashboards can make reporting easy. In-app reminders can also enable independent physicians to stay on top of compliance for this performance category.
Key Takeaways:
-The Advancing Care Information performance category has simplified Meaningful Use requirements.
-Reporting burdens for EHR usage are reduced; physicians now receive proportional scores based on their technology use — no more pass/fail scoring.
-This performance category emphasizes measures that improve patient engagement and is is flexible to meet the needs of independent practices.
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