• MIPS 2018—PI: Next, You Can Earn a Performance Score

    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. Note: Promoting interoperability (PI) was previously known as advancing care information (ACI).


    For the promoting interoperability (PI) performance category, you are eligible for the PI performance score only if you achieved the base score. (See First, Meet Promoting Interoperability’s Base Score Requirements.)

    Most performance score measures are optional. However, some performance score measures are also required for the base score.

    Report as many as 7 or 9 performance score measures, depending on which measure set you use. You either use the 2018 PI transition measure set (see Table 15 [PDF], or review the measures online) or the PI measure set (see Table 16 [PDF]) 

    The 2018 PI transition measure set contains 7 performance score measures:

    • 1 is strictly mandatory.
    • 1 is typically required, but you may be able to claim an exclusion; and
    • 5 are optional.

    The ACI measure set contains 9 performance score measures:

    • 1 is strictly mandatory
    • 2 are typically required, but you may be able to claim exclusions
    • 6 are optional.

    Your score for a performance score measure will typically depend on your performance rate. Most performance score measures are assigned a score of 0%-10% using decile-based scoring: You get a score of 1% if your performance rate is in the first decile (1%-10%), 2% if it is in the second decile (11%-20%), etc. If your performance rate falls between deciles, it is rounded off to the nearest integer; if it is below 1% but greater than 0%, it is rounded up to 1%.

    How the performance rate is scored. Suppose you report the Patient-Specific Education measure, which can contribute up to 10% to your performance score. During the performance period, perhaps you see 600 unique patients—this is the denominator. You provided patient-specific educational resources to 200 of those patients (or to their authorized representatives) electronically using clinically relevant information identified from your EHR—this is your numerator. To calculate your performance rate, divide the numerator by the denominator and turn the resulting fraction into a percentage. In this case, your performance rate would be 33.3% (200/600), and—as indicated in Table 14 (see below)—this measure will contribute 4% to your ACI score.

    Exception to performance rate–based scoring. You earn 10% toward your performance score by either performing the Immunization Registry Reporting measure or—more feasible for ophthalmologists—engaging with a clinical data registry, such as the IRIS Registry, or a public health agency and reporting an alternate measure (see A New Way to Boost Your Performance Score).

    Table 14: PI’s Decile-Based Scoring for Performance Measures

    Performance Rate (Numerator/Denominator) Your Score*
    0%* 0%
    1%-10% 1%
    11%-20% 2%
    21%-30% 3%
    31%-40% 4%
    41%-50% 5%
    51%-60% 6%
    61%-70% 7%
    71%-80% 8%
    81%-90% 9%
    91%-100% 10%

    Note: This scoring applies to PI performance score measures and 2018 PI transition performance score measures that score from 0%-10%. 

    *If your performance rate is greater than 0% but less than 1%, it will be rounded up to 1%.

    ___________________________

    Previous: PI: Exclusions Available for Some Base Score Measures.

    Next: PI: A New Way to Boost Your Performance Score.

    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.

    COPYRIGHT© 2018, American Academy of Ophthalmology, Inc.® All rights reserved. No part of this publication may be reproduced without written permission from the publisher. American Academy of Ophthalmic Executives® and IRIS® Registry are trademarks of the American Academy of Ophthalmology®.