Promoting Interoperability - 2019 (PCP)

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Video Time: 11:24
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Weight to final score:

25% in Year 3

 

Reweighting:

  • Reweighting of the Promoting Interoperability performance category remains the same as Year 2 and extends to additional MIPS eligible clinician types added for Year 3:
  • Physical Therapists,
  • Occupational Therapists,
  • Speech-language Pathologists,
  • Audiologists,
  • Clinical psychologists, and
  • Registered dietitians or nutrition professionals.

 

Certification Requirements:

Eligible clinicians must use 2015 Edition CEHRT in Year 3.

 

Scoring:

  • Eliminating base, performance, and bonus scores.
  • Finalizing a new scoring methodology.
  • Performance-based scoring at the individual measure-level. Each measure will be scored based on the MIPS eligible clinician’s performance for that measure based on the submission of a numerator or denominator, or a “yes or no” submission, where applicable.
  • Finalizing Security Risk Analysis measure as a required measure without points.
  • The scores for each of the individual measures will be added together to calculate the score of up to 100 possible points. If exclusions are claimed, the points for measures will be reallocated to other measures.

 

Objectives and Measures

  • One set of objectives and measures based on the 2015 Edition CEHRT.
  • Four objectives: e-Prescribing, Health Information Exchange, Provider to Patient Exchange, and Public Health and Clinical Data Exchange.
  • Clinicians are required to report certain measures from each of the four objectives, unless an exclusion is claimed.
  • Finalizing adding two new measures for the e-Prescribing objective: Query of Prescription Drug Monitoring Program (PDMP) and Verify Opioid Treatment Agreement as optional with bonus points available.

MACRA Acronyms, Terms & Definitions Explained for 2019

To help clarify some of the terms surrounding Medicare Access and CHIP Reauthorization Act (MACRA), the AMA has compiled a list of acronyms, terms and definitions.

A

ABC™ - Achievable Benchmark of Care

ACO - accountable care organization

AHRQ - Agency for HealthCare Research and Quality

APM - alternative payment model

APRN - advanced practice registered nurse

ASPE - HHS’ Office of the Assistant Secretary for Planning and Evaluation

AUC - appropriate use criteria

B

BPCI - bundled payments for care improvement

C

CAH - critical access hospital

CAHPS - Consumer Assessment of Healthcare Providers and Systems

CBSA - non-core based statistical area

CDS - clinical decision support

CEHRT - certified EHR technology

CFR - Code of Federal Regulations

CHIP - Children’s Health Insurance Program

CJR - comprehensive care for joint replacement

CMMI - Center for Medicare & Medicaid Innovation (CMS Innovation Center)

CMS - Centers for Medicare and Medicaid Services

COI - collection of information

CPIA - clinical practice improvement activity

CPOE - computerized provider order entry

CPR - customary, prevailing and reasonable

CPS - composite performance score

CPT - Current Procedural Terminology

CQM - clinical quality measure

CY - calendar year

D

DPP - diabetes prevention program

E

eCQM - Electronic Clinician Quality Measure

ED - Emergency Department

EHR - electronic health record

EP - eligible professional

ESRD - End-stage Renal Disease

F

FFS - fee for service

FQHC - federally qualified health center

FR - Federal Register

G

GAO - Government Accountability Office

GPCI - Geographic Practice Cost Index

H

HAC - hospital-acquired condition

HCAHPS - Hospice Consumer Assessment of Healthcare Providers and Systems

HHS - Department of Health & Human Services

HIE - Health Information Exchange

HIPAA - Health Insurance Portability and Accountability Act of 1996

HITECH - Health Information Technology for Economic and Clinical Health

HOPD - Hospital Outpatient Department

HPSA - health professional shortage area

HRSA - Health Resources and Services Administration

I

IHS - Indian Health Service

IPAB - Independent Payment Advisory Board

IT - information technology

L

LDO - large dialysis organization

M

MA - medical assistant

MAC - Medicare Administrative Contractor

MACRA - Medicare Access and CHIP Reauthorization Act of 2015

MedPAC - Medicare Payment Advisory Commission

MEI - Medicare Economic Index

MIPAA - Medicare Improvements for Patients and Providers Act of 2008

MIPS - Merit-based Incentive Payment System

MLR - minimum loss rate

MSPB - Medicare spending per beneficiary

MSR - minimum savings rate

MU - Meaningful Use

MUA - medically underserved area

N

NCQA - National Committee for Quality Assurance

NPI - National Provider Identifier

NQF - National Quality Forum

O

OCM - Oncology Care Model

OIG - Office of the Inspector General

ONC - Office of the National Coordinator for Health Information Technology

P

PCMH - patient-centered medical home

PCORI - Patient-centered Outcomes Research Institute

PECOS - Medicare Provider Enrollment, Chain and Ownership System

PFPMs - physician-focused payment models

PFS - physician fee schedule

PHS - public health service

PPS - prospective payment system

PQRS - Physician Quality Reporting System

PTAC - Physician-focused Payment Model Technical Advisory Committee

Q

QCDR - qualified clinical data registry

QIO - quality improvement organization

QP - qualifying APM participant

QPP - Quality Payment Program

QRDA - quality reporting document architecture

QRUR - quality and resource use reports

R

RAC - recovery audit contractor

RBRVS - Resource-based Relative Value Scale

RFI - request for information

RHC - rural health clinic

RIA - regulatory impact analysis

RVU - relative value unit

S

SGR - sustainable growth rate

T

TCPI - Transforming Clinical Practice Initiative

TIN - tax identification number

V

VBM - value-based payment modifier

VPS - volume performance standard