• Advancing Care Information in the Merit-Based Incentive Payment System

  • Under the Quality Payment Program, CMS renamed the old Medicare and Medicaid Electronic Health Record Incentive Program advancing care information and combined it with two other programs.

    • To avoid a 2019 penalty, physicians must complete the minimum in at least one performance category during 2017 (quality reporting, advancing care information or improvement activities).
    • You don’t have to report advancing care information measures to avoid a 2019 penalty for 2017 performance, but CMS will change category weights in future years.

    To report advancing care information measures for 2017, you must:

    • Use an electronic health record system that meets 2014 certification standards.
    • Report either a set of 4 base measures (the minimum for the performance category) or a set of 9 performance measures to qualify for a possible bonus.
    Program Component2016 and before2017
    Name Meaningful use Advancing care information
    Penalty for non-performance Tied to program performance alone; varied by year Depends on overall MIPS performance
    Stages Graduated, based on years in program Same for all
    Ways to participate Physicians progressed through multiple stages Report base or performance measures
    Measures available 16 measures across 10 functional objectives + 9 physician-chosen clinical quality measures 4-5 for the base score; 9 for the performance score

    2017 Reporting Options

    To complete the minimum for the category, providers must report on all four base measures.

    1. Attest to security risk analysis (objective 1).
    2. E-prescribe to at least one patient.
    3. Provide patient access through a portal within four business days for at least one patient AND
      Send a summary of care to a clinician to whom you refer or transition a patient (health-information exchange measure).

    You’ll earn 12.5 points toward your MIPS composite score – enough to avoid a 2019 penalty.

    To get more than 12.5 points toward your MIPS composite score, you must:

    1. Attest to security risk analysis (objective 1).
    2. E-prescribe to at least one patient.
    3. Report more than one patient on the two remaining base measures.
    4. Report more than one patient on five performance measures.

    Points earned depend on the percent of patients you choose to report.

    Reporting Options

    New for 2017, you can complete all attestations to advancing care information either:

    1. Through the CMS attestation site; OR
    2. Through the Academy’s IRIS® Registry.

    CMS offers limited hardship exceptions from reporting, under which the agency reweights your quality-reporting performance.

    EHR System Requirements

    To report advancing care information measures for 2017, physicians must have EHR technology that meets 2014 edition U.S. Department of Health and Human Services certification standards. The Department of Health and Human Services maintains a list of certified EHR systems.

    In 2018, all physicians will be required to use technology that meets the 2015 edition certification standards.

    Medicaid Meaningful Use Program

    Medicaid continues to operate a state-specific meaningful use program, separate from the Medicare version that rolled into the Quality Payment Program.

    • Attesting to the Medicaid program does not count toward CMS requirements for advancing care information.
    • Reporting for advancing care information does not count toward requirements for the Medicaid program.
    • To qualify for the Medicaid EHR Incentive Program, at least 30 percent of a provider’s patients must be on Medicaid. Requirements can vary by state.

    Check with your state for their meaningful use requirements.