Health Information Exchange and MIPS/MACRA
SHARE gathers patients’ clinical data from all participating health care providers to instantly give providers a holistic view of their patients’ health history, treatment and progress. SHARE allows care teams to coordinate patient care with other providers and provides critical information about patients to the entire care coordination team across all stages of care.
MIPS & MACRA Overview (https://qpp.cms.gov/resources/resource-library): The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (H.R. 2, Pub.L. 114–10) ended the Sustainable Growth Rate (SGR) formula, which would have resulted in a significant cut to payment rates for clinicians participating in Medicare. In response to MACRA, the Centers for Medicare & Medicaid Services (CMS) created a federally mandated Medicare program, the Quality Payment Program (QPP) that seeks to improve patient care and outcomes while managing the costs of services patients receive from clinicians. Clinicians providing high value/high quality patient care are rewarded through Medicare payment increases, while clinicians not meeting performance standards have a reduction in Medicare payments. Clinicians may participate in the QPP through MIPS or MACRA.
Below: Performance category weights for the 2023 performance period (Courtesy Center for Medicare and Medicaid Services (CMS.gov))
Meaningful Use and the Shift to the Merit-Based Incentive Payment System
The Merit-based Incentive Payment System (MIPS) is a part of the Medicare Access and CHIP Reauthorization Act (MACRA). Since the introduction of MACRA, meaningful use was transitioned into becoming one of four components of MIPS.
MIPS harmonizes existing Center for Medicare and Medicaid Services (CMS) quality programs (including meaningful use), the Physician Quality Reporting System, and Value-Based Payment Modifiers. MIPS consolidates multiple, quality programs into a single program to improve quality care.
To increase Promoting Interoperability Performance category score: Join SHARE and send data to the Arkansas immunization registry, which can help health care facilities earn the full 25 Points for the objective 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 category 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). Providers can also sign up for 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 Certified EHR Technology (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.
To view the SHARE Secure Messaging Certification, click here.
Medicare Promoting Interoperability Program
To increase Promoting Interoperability Performance category score (Formerly the Advancing Care Information Performance Category, ACI): Join SHARE and send data to the Arkansas immunization registry, which can help health care facilities 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 category 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). Providers can also sign up for 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 Certified EHR Technology (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.
To view the SHARE Secure Messaging Certification, click here.
The Medicare Promoting Interoperability Program provides objectives and measures for eligible hospitals, critical access hospitals and dual-eligible hospitals.
