This content was excerpted from EyeNet’s MIPS 2019; also see the Academy’s MIPS hub page.
PI is now arranged around four objectives: 1) e-Prescribing; 2) Health Information Exchange; 3) Provider to Patient Exchange; and 4) Public Health and Clinical Data Exchange. Each objective has at least one measure associated with it.
For most PI objectives, scoring for measures is based on your performance rate. You can, for example, score up to 10 points for the e-prescribing measure; if your performance rate is 82%, you would score 8 points. (Note: In calculating this point score, CMS typically rounds off to the nearest whole number. The exception is when the nearest whole number is 0 points; provided you have reported on at least one patient, CMS will round up to 1 point.)
Your performance rate is based on a numerator and a denominator. For the e-Prescribing measure, to continue the example, the denominator is the number of prescriptions written for drugs during the performance period and the numerator is the number of those prescriptions that were 1) generated, 2) queried for a drug formulary, and 3) transmitted using a certified EHR. You need a numerator of at least 1 to successfully report the measure. (For information on the numerators and denominators of the performance rate–based measures, see the Academy's detailed web pages on all the PI measures.)
Exceptions: Scoring is not performance rate–based for the Public Health and Clinical Data Exchange objective. For the five measures that involve reporting to registries or public health agencies, you attest “yes” or “no” to indicate whether you are actively engaged with registries or public health agencies. Scoring for this objective is on a pass/fail basis, with 10 points for a pass and 0 points for a fail. To pass, either 1) provide two “yes” responses or 2) provide one “yes” response and claim one exclusion. If you provide no “yes” responses but claim two exclusions, the 10 points will be reallocated to the Provider to Patient Exchange objective. Note: To be actively engaged with a registry or agency, you must be either sending production data to the entity or in the process of moving toward doing so. (For a more complete definition of active engagement, see the measure descriptions.)
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