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MIPS/MACRA

Health Information Exchange and MIPS/MACRA

The Merit-based Incentive Payment System (MIPS) is part of the Medicare Access and CHIP Reauthorization Act (MACRA) that was signed into law in 2015. For those clinicians participating in the MIPS track, this year is a transition year deemed Pick Your Pace or one patient, one measure, no penalty as clinicians just need to report one patient under one measure to avoid the 2019 payment adjustment from CMS.

 

As providers prepare to participate in the full MIPS track next year, they will need to improve their chances of a high score in the four performance categories of Quality, Cost, Improvement Activities and Advancing Care Information. Participating in the SHARE health information exchange can help with Advancing Care Information (ACI), which replaces Meaningful Use for Medicare participants, and Improvement Activities.


To increase your ACI category score:

Join SHARE and send your data to the state’s immunization registry, which can help you earn the full 10% for this performance measure. The immunization registry reporting measure is the only yes/no performance score measure. 


Measure description: The MIPS-eligible clinician is in active engagement with a public health agency to submit immunization data and receive immunization forecasts and histories from the public health immunization registry/immunization information system (IIS).

To increase Improvement Activities score:

Send care summaries, or continuity of care documents (CCDs), into the SHARE health information exchange, which counts as medium weight activity for the Improvement activities category (small practices need 2 medium-weighted activities or 1 high-weighted activity). You can also sign up with Direct Messaging from SHARE to send care summaries as part of referrals to other Direct-enabled providers. 

Measure description: The MIPS-eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits the summary to a receiving health care clinician for at least one transition of care or referral.

To increase providers' cost category score:

Join SHARE and receive clinical results on your patients to improve your overall costs and utilization by educating patients on hospital utilization. (The cost category will measure the Medicare Part A and Part B costs of care related to inpatient hospital visits.) Next year, the weight of the cost category will account for 10% of overall MIPS score, so getting started now will be important to prepare for this shift. 

Contact Us today to get these projects started and position your organization to be successful in the MIPS program.