• MIPS 2018—What’s New for Promoting Interoperability (Formerly ACI)

    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


    Unlike quality, the promoting interoperability (PI) performance category retains the same contribution to your MIPS final score (0-25 points) as it did in 2017, as well as the same performance period (at least 90 consecutive days). Here’s what has changed.

    New name! CMS changed the name of this performance category from advancing care information (ACI) to promoting interoperability. Because this happened recently—on April 24—you can expect to see the old ACI terminology on most MIPS materials, including the EyeNet supplement, MIPS 2018: A Primer and Reference, which went to print before the name change was announced.

    New hardship exceptions for the promoting interoperability performance category. In certain circumstances, you can apply for a PI exception. This year, CMS has added exceptions for small practices and for practices whose EHR system has been decertified. If CMS approves your application for a PI exception, you can opt out of reporting the PI performance category. To ensure you aren’t penalized for that, CMS reweights how your performance category scores contribute to your MIPS final score: PI will contribute 0 points (instead of 0-25 points) and quality will contribute 0-75 points (instead of 0-50 points). Like last year, there also are some automatic PI exceptions.

    Exclusions continued for some base score measures. In November of last year, CMS introduced exclusions for some of the base score measures. These exclusions have been carried over to 2018.

    A new bonus for using only 2015-edition CEHRT. You can earn a 10% bonus to your PI score if you report the PI measure set using only 2015-edition certified EHR technology for at least 90 consecutive days.

    An alternative to the Immunization Registry Reporting measure. In 2017, if you reported the Immunization Registry Reporting measure, you could earn 10% toward your PI performance score. That is still an option for 2018, but CMS has provided an alternate option. Instead of engaging with an immunization registry, you can earn that 10% toward your performance score by engaging with an alternate registry or agency and reporting an alternate measure. Furthermore, the measure can be reported a second time using a different registry or agency to earn a 5% registry/agency bonus score. See A New Way to Boost Your ACI Score.

    Suppose, for example, you integrate your EHR system with the IRIS Registry. Instead of reporting the Immunization Registry measure, you could report an alternate measure—e.g., the Specialized Registry Reporting measure—and earn 10% toward your performance score. But you couldn’t use your active engagement with the IRIS Registry to also earn the 5% registry/agency bonus; instead, you would have to engage with a second registry.

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    Next: What’s New for Improvement Activities.

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