The Centers for Medicare and Medicaid Services (CMS) recently released the detailed specifications for the Advancing Care Information (ACI) performance category within the Merit Based Incentive Payment System (MIPS). In celebration, Able Health has compiled a list of the five most common questions we receive related to the ACI performance category.
The ACI performance category includes five base measures, all of which must be reported in order to earn any points in the category. Together, the base measures account for 50% of the performance category score, and reporting data for additional performance and bonus measures will account for the rest of the category score. The maximum score in the category is 100%, even though it is possible to report data that would earn more than 100%. Below is a detailed outline of the measures available and scores associated.
|Advancing Care Information Measure||￼Advancing Care Information Objective||Required for Base Score (50%)?||Contribution to Performance Score (up to 50%)||Reporting Requirement|
|Security Risk Analysis||Protect Patient Health Information||Required||0||Yes/No statement|
|Provide Patient Access||Patient Electronic Access||Required||Up to 10%||Numerator/Denominator|
|Patient-Specific Education||Patient Electronic Access||Not Required||Up to 10%||Numerator/Denominator|
|View, Download, or Transmit (VDT)||Coordination of Care Through Patient Engagement||Not required||Up to 10%||Numerator/Denominator|
|Secure Messaging||Coordination of Care Through Patient Engagement||Not required||Up to 10%||Numerator/Denominator|
|Patient-Generated Health Data||Coordination of Care Through Patient Engagement||Not required||Up to 10%||Numerator/Denominator|
|Send a Summary of Care||Health Information Exchange||Required||Up to 10%||Numerator/Denominator|
|Request/Accept Summary of Care||Health Information Exchange||Required||Up to 10%||Numerator/Denominator|
|Clinical Information Reconciliation||Health Information Exchange||Not required||Up to 10%||Numerator/Denominator|
|Immunization Registry Reporting||Public Health and Clinical Data Registry Reporting||Not required||0 or 10%||Yes/No statement|
|Syndromic Surveillance Reporting||Public Health and Clinical Data Registry Reporting||Not required||Bonus||Yes/No statement|
|Electronic Case Reporting||Public Health and Clinical Data Registry Reporting||Not required||Bonus||Yes/No statement|
|Public Health Registry Reporting||Public Health and Clinical Data Registry Reporting||Not required||Bonus||Yes/No statement|
|Clinical Data Registry Reporting||Public Health and Clinical Data Registry Reporting||Not required||Bonus||Yes/No statement|
In addition, the following measures can be reported for a bonus of up to 15%, which can contribute to the total category score of up to 100% as longs at the base measures are met:
|Measure||Category Bonus||Reporting Requirement|
|Report to one or more additional public health and clinical data registries beyond the Immunization Registry Reporting measure||5% bonus||Yes/No statement|
|Report improvement activities using CEHRT||10% bonus||Yes/No statement|
Yes, CMS has finalized the policy to re-weight the advancing care information performance category to zero percent of the MIPS final score for MIPS eligible clinicians facing a significant hardships. Like under the Meaningful Use program, CMS continues to assume that the clinicians facing the hardships listed below may not have sufficient measures applicable and available to them for the Advancing Care Information performance category. Categories of significant hardship include:
If a MIPS eligible clinician is exempt from reporting for the ACI category based on significant hardship, the ACI score will be set to zero, and the 25 points will be moved to the Quality performance category.
If a MIPS eligible clinician applies for their Advancing Care Information performance category to be reweighted under this policy but subsequently determines that their situation has changed and they believe there are sufficient ACI measures applicable and available to them, they may report on the measures. If they choose to report, they will be scored on the Advancing Care Information performance category like any other MIPS eligible clinician.
No, there will be a new reporting system for ACI. CMS has finalized the policy that ACI measures will be able to be reported via EHR, Registry, QCDR, and attestation. The ability to report ACI measures via Registry and QCDR is new under MIPS, and CMS has stated that they are encouraging consolidation of reporting for all categories through a single submission mechanism.
Keep your eye on qpp.cms.gov throughout the year for new resources related to ACI measure reporting.
For group reporting, the ACI data must be aggregated for the group, with one numerator and denominator or yes/no answer for the whole group for each measure. If the group is using multiple EHR technologies, the numbers must be aggregated across the technologies before the data is reported. Here is some additional detail on reporting ACI base measures and performance measures as a group:
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