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Quality Payment Program: Advancing Care Information Performance Category Part 2

Hess, Cathy Thomas BSN, RN, CWCN

Advances in Skin & Wound Care: June 2017 - Volume 30 - Issue 6 - p 288
doi: 10.1097/01.ASW.0000516739.53576.be
Departments: Practice Points

Cathy Thomas Hess, BSN, RN, CWCN, is Vice President and Chief Clinical Officer for Wound Care, Net Health. Ms Hess presides over Net Health 360 WoundExpert Professional Services, which offers products and solutions to optimize process and workflows. Address correspondence to Ms Hess via e-mail: chess@nethealth.com.

In last month’s column, we discussed the first part of the “Quality Payment Program: Advancing Care Information Performance Category” and focused on how the Advancing Care Information (formerly known as Meaningful Use) could be reweighted based on select criteria. We also reviewed measure set options for reporting. In this column, we review how the base, performance, and bonus scores are calculated. The following information is directly excerpted from the Quality Payment Program’s Advancing Care Information Performance Category Fact Sheet.1

How is the base score calculated? Merit-based Incentive Program System (MIPS)–eligible clinicians need to fulfill the requirements of all the base score measures in order to receive the 50% base score. If these requirements are not met, they will get a “0” in the overall Advancing Care Information performance category score. In order to receive the 50% base score, MIPS-eligible clinicians must submit a “yes” for the security risk analysis measure and “at least a 1” in the numerator for the numerator/denominator of the remaining measures. In 2017, there are 2 measure set options for reporting:

  • Advancing Care Information objectives and measures
  • 2017 Advancing Care Information transition objectives and measures

The option you will use to send in data is based on your Certified Electronic Health Record Technology edition.

The base score Advancing Care Information measures are as follows:

  1. security risk analysis
  2. e-prescribing
  3. provide patient access
  4. send a summary of care
  5. request/accept summary of care

The base score 2017 Advancing Care Information transition measures are as follows:

  1. security risk analysis
  2. e-prescribing
  3. provide patient access
  4. health information exchange

As we have discussed, all base score requirements must be met to receive the 50% base score and be able to receive a score in the Advancing Care Information category. In addition, it is important to note that some of the base score measures can also contribute toward the performance score.

How is the performance score calculated? The performance score is calculated by using the numerators and denominators submitted for measures included in the performance score, or for 1 measure, by the yes or no 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 2 measures reported under the 2017 Transition measures, which are worth up to 20 percentage points.

Example: If a MIPS-eligible clinician submits a numerator and denominator of 85/100 for the Patient Specific Education measure, his/her performance rate would be 85%, and he/she would earn 9 of 10 percentage points for that measure.

Table

Table

The only performance score measure that is yes/no is the Immunization Registry Reporting measure. The MIPS-eligible clinicians in active engagement with a public health agency to submit immunization data who submit a “yes” for this measure would receive the full 10%.

How is the bonus score calculated? The MIPS-eligible clinicians can earn bonus percentage points by doing the following:

  • Reporting “yes” to 1 or more additional public health and clinical data registries beyond the Immunization Registry Reporting measure will result in a 5% bonus.
  • Reporting “yes” to the completion of at least 1 of the specified Improvement Activities using Certified Electronic Health Record Technology will result in a 10% bonus. See Appendix B1 within the “Quality Payment Program’s Advancing Care Information Performance Category Fact Sheet” for the list of Improvement Activities that may be completed using certified electronic health record technology to qualify for the bonus. The MIPS-eligible clinicians who meet both requirements will receive a 15% bonus score.
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REFERENCE

1. Centers for Medicare & Medicaid Services. Advancing Care Information Performance Category Fact Sheet. https://qpp.cms.gov/docs/QPP_ACI_Fact_Sheet.pdf. Last accessed April 26, 2017.
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