• MIPS 2018—PI: Getting Started With Promoting Interoperability: CEHRT, 2 Measure Sets, and Different Levels of Participation

    Written By: Rebecca Hancock, Flora Lum, MD, Chris McDonagh, Cherie McNett, Jessica Peterson, MD, MPH, and Sue Vicchrilli, COT, OCS

    This content was excerpted from EyeNet’s MIPS 2018; also see the Academy’s MIPS hub page


    The promoting interoperability (PI) performance category was formerly known as advancing care information (ACI). It evolved out of the meaningful use (MU) program for electronic health records (EHRs). It contributes up to 25 points to your 2018 MIPS final score.

    Getting Started

    You must have an EHR system that is a certified EHR technology (CEHRT). What certification do you need? During the 2018 performance year, your EHR system must have 2014- or 2015-edition certification; modular EHR systems can have a mixture of 2014- and 2015-edition modules. New this year: You can get a bonus for using a 2015-edition CEHRT (see 3 Bonuses Are Available).

    Check your EHR system’s certification. To check whether your EHR system is a 2014- or 2015-edition CEHRT, visit https://chpl.healthit.gov/#/search.

    Select a reporting mechanism. The Academy recommends that you attest to your PI measures via the IRIS Registry web portal, but you also can do so via the CMS web portal or possibly via your EHR vendor.

    There is no automated reporting of PI measures; you must do so manually. Regardless of your reporting mechanism, you will report your PI measures manually. Ask your EHR vendor for a report that supplies the data that you need to submit when reporting the PI measures.

    There Are 2 Measure Set Options for This Performance Category

    This year, you will report measures either from:

    PI’s 2 measure sets were adapted from the EHR meaningful use program. The PI transition measures were adapted from the modified stage 2 meaningful use measures, and the PI measures were adapted from the stage 3 meaningful use measures. This year’s measures are largely the same as last year’s, with a few small changes.

    The set of measures that you can report depends on whether you have 2014- or 2015-edition CEHRT:

    • If your EHR system has 2014-edition certification, it will have the functionality to support reporting of the 2018 PI transition measure set.
    • If your EHR system has 2015-edition certification, you can choose whether you want to report the PI measure set or the 2018 PI transition measure set.
    • If you took the modular approach and have a mixture of 2014- and 2015-edition CEHRT modules, you can choose either the PI measure set or the 2018 PI transition measure set, provided your EHR system is able to support the measures that you select.

    The Performance Period Is at Least 90 Days

    Pick a performance period of at least 90 consecutive days and no more than a calendar year. Because CMS anticipates that many practices will be moving from 2014- to 2015-edition CEHRT in the next year, PI’s performance period for 2019 is also slated for 90 days. CMS has said that it will consider a 90-day performance period for PI in 2020, but ultimately it plans to implement a 12-month performance period.

    There Are Different Levels of Participation

    Under PI, there is a base score and a performance score:

    • The base score represents a mandatory core level of participation.
    • The performance score involves a second level of participation where you are rewarded for your performance rate.

    You also can earn 3 bonus scores:

    • You can earn a 5% bonus by being actively engaged with a registry or a public health agency.
    • The second bonus relates to how you perform in another performance category: Improvement activities. If you use specific CEHRT functionalities to complete at least 1 PI bonus–eligible improvement activity, you’ll earn a 10% PI bonus.

    You also can earn a 10% bonus if you report the PI measure set using only 2015-edition CEHRT. (See 3 Bonuses Are Available.)

    Table 13: Calculating Your Score for Promoting Interoperability (Formerly ACI)

    Base score 0% or 50% Report (or claim exclusions for) 4 base score measures from the 2017 PI transition measure set or 5 from the PI measures set.
    performance score 0%-90% Report up to 7 performance score measures from the 2017 PI transition measure set or up to 9 from the PI measures set.
    + registry/agency bonus score 0% or 5% Report at least 1 bonus score measure involving active engagement with a clinical data registry or public health agency.
    CEHRT for improvement activities bonus score 0% or 10% Use CEHRT functionalities to complete an improvement activity that is eligible for the PI bonus.
    2015-CEHRT bonus score 0% or 10% During your PI performance period, report the PI measure set using only 2015-edition CEHRT.
    = ACI score 0%-100% Your ACI score is capped at 100%.
    Your ACI score contributes up to 25 points to your MIPS final score (0-100 points). For instance, an ACI of 80% contributes 20 points to your MIPS final score.

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    Previous: Quality: How CMS Calculates Your Quality Score.

    Next: PIFirst, Meet Promoting Interoperability’s Base Score Requirements.

    Note: Meeting regulatory requirements is a complicated process involving continually changing rules and the application of judgment to factual situations. The Academy does not guarantee or warrant that regulators and public or private payers will agree with the Academy’s information or recommendations. The Academy shall not be liable to you or any other party to any extent whatsoever for errors in, or omissions from, any such information provided by the Academy, its employees, agents, or representatives.

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