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MIPS Interoperability: Improving Efficiency and Patient Care 

With the implementation of electronic health records (EHRs), healthcare providers, including nurse practitioners (NPs) are now in a better position to deliver quality and efficient care to their patients. However, to maximize the benefits of these systems, NPs need to know how to use them effectively. This is where electronic case reporting (eCR) – which is required under the Merit-based Incentive Payment System (MIPS) promoting interoperability – comes in.  

The 2015 Edition Cures Update MIPS, established by the Centers for Medicare and Medicaid Services (CMS), laid the foundation for promoting interoperability. The program seeks to promote the seamless exchange of health information between different healthcare providers. At the end of the performance period, it also rewards MIPS eligible clinicians who adopt and use certified EHRs to promote patient engagement, enhance communication, and improve population health management. 

Understanding MIPS Promoting Interoperability 

Promoting Interoperability Measures (formerly known as Advancing Care Information) is one of the four performance categories under the MIPS program. This measure rewards clinicians for the use of certified electronic health record technology (CEHRT) in their practice. NPs who utilize 2015 Edition CEHRT systems can achieve better patient outcomes, meet regulatory requirements, and increase their efficiency.  

In today’s interconnected world, patients are increasingly demanding more personalized and efficient healthcare services. The MIPS promoting interoperability program helps medical professionals achieve these demands by promoting the adoption of advanced health information technology (HIT) systems. By using certified EHRs, clinicians can easily exchange health information with other providers, reduce medical errors, and improve patient outcomes. 

Key MIPS Promoting Interoperability Requirements 

According to Centers for Medicare & Medicaid Services (CMS), the promoting interoperability performance category emphasizes the electronic exchange of information using CEHRT to improve patient access to their health information, the exchange of information between health care providers, and the systemic collection, analysis, and interpretation of healthcare data. 

To participate in the MIPS promoting interoperability program, clinicians need to follow specific measures outlined by CMS. Some of the key requirements of MIPS promoting interoperability measures include: 

  • Sending and receiving patient care summaries for at least 50 percent of transitions of care and referrals 
  • Submitting immunization data to a state immunization registry 
  • Providing patients with access to their health information via a patient portal 
  • Reporting on e-prescribing 
  • Reporting on measures that test the exchange of information with other CEHRT systems 

Other certification criteria include conducting a security risk assessment, implementing e-prescribing, using clinical decision support tools, and submitting data to public health registries. 

The Impact of the Promoting Interoperability Category for Your Practice 

Since 2018, CMS has required providers to report on interoperability activities as part of MIPS. Interoperability accounts for 25% of the overall MIPS score, so participating in this category is critical to receiving higher scores and avoiding payment penalties. To receive points for interoperability, providers must complete activities related to data sharing, patient access and engagement, and health information exchange. These activities include sending and receiving data from other providers, using certified EHR technology to meet ONC standards, and giving patients access to their health information via online portals.  

For example, for the Public Health and Clinical Data Exchange objective, clinicians report using “yes or no” responses. The MIPS eligible clinician will receive the full 10 points for reporting two “yes” responses for the two required measures, or for submitting a “yes” for one measure and claiming an exclusion for another. If there are no “yes” responses and two exclusions are claimed, the 10 points will be redistributed to the Provide Patients Electronic Access to Their Health Information measure. Or, if you are identified as hospital-based, you qualify for automatic reweighting of the Promoting Interoperability performance category to 0%.  

Improving interoperability can provide financial and operational benefits to healthcare providers. Under MIPS, providers who achieve a high score in the interoperability category can receive positive payment adjustments of up to 10% of their Medicare Part B reimbursements, while providers who fail to report any interoperability activities may be subject to payment penalties. Additionally, interoperability can help reduce operating costs by streamlining the flow of data and improving patient outcomes.  

Ensuring that data is accurate, complete, and secure is critical to facilitating interoperability, and many providers may find that they need to upgrade their existing technology infrastructure to meet ONC standards. Additionally, providers must obtain the necessary consents and opt-in requirements and make sure their staff are trained on how to use online portals to implement interoperability successfully. 

Implementing MIPS Promoting Interoperability Measures in Your Practice 

Before you can start implementing MIPS promoting interoperability measures in your medical practice, there are several steps that you need to take. First, familiarize yourself with the requirements of this program. Make sure you understand the objectives, measures, special status eligibility (especially for small practices), and scoring methodology. Next steps include a thorough evaluation of your current EHR system to see if it meets the MIPS interoperability measures. Finally, you must identify any gaps in your interoperability process, and determine the steps you need to take to address them. 

Once you have familiarized yourself with the requirements and prepared your medical practice, you can begin implementing the MIPS promoting interoperability measures. Some of the essential steps to take include upgrading to a certified health IT product to meet the requirements, ensuring you can exchange data securely with other healthcare providers, and creating an effective care coordination plan to deliver quality care to your patients. 

Choosing the Right EHR 

MIPS promoting interoperability measures encourage NPs to utilize CEHRT systems in their practice. CEHRT systems provide a platform for practices to store, manage, and retrieve critical patient health data. This data can include medical history, lab results, medications, and diagnostic images. CEHRT systems improve patient care by providing a full overview of their medical history, enhancing treatment management, and improving communication within the healthcare team. 

  • Evaluate the EHR system’s interoperability capabilities: The EHR system you choose should have the capability to allow data sharing with other healthcare providers, including hospitals, labs and pharmacies, and referral NPs to ensure seamless care coordination. 
  • Look for CEHRT: The certification ensures that the software meets the required standards of interoperability, security, and privacy. The use of an uncertified EHR system may result in penalties and loss of incentives. 
  • Security risk analysis: The EHR system should have advanced access control mechanisms, password policies, and auditing features and conform to HIPAA and HITECH data protection regulations. 

Benefits of Implementing MIPS Promoting Interoperability Measures 

There are multiple benefits of implementing the MIPS promoting interoperability measures in your independent NP practice. Implementing MIPS promoting interoperability measures enhances the quality of care and overall patient satisfaction, which can lead to increased referrals, profitability, and a better reputation for your medical practice. Additional benefits of MIPS promoting interoperability measures include: 

  • Improved patient outcomes and quality of care 
  • Streamlined workflows and reduced administrative work 
  • Increased NP productivity, efficiency, and accuracy 
  • Improved interoperability and communication within the healthcare team 
  • Cost savings for the practice 

Improving Patient Experience and Streamlining Clinical Decision Making 

Promoting Interoperability (PI) measures were introduced under the Merit-Based Incentive Payment System (MIPS) to promote better patient care and outcomes through the use of information technology. The primary aim of these measures is to encourage healthcare professionals to use health information technology (HIT) in a more meaningful way to improve healthcare quality, outcomes, and care coordination. It also empowers patients to actively manage their own health. 

Additionally, by improving communication and collaboration between clinicians, patients are better positioned to receive personalized and effective care. Other benefits include:  

  • Improved patient safety: With access to their records, patients can identify any errors in their medical records, such as inaccurate medication lists. They can also benefit from enhanced communication between providers, reducing the risk of miscommunication and errors. 
  • Better care coordination: MIPS also helps to improve the coordination of care by giving different providers access real-time patient data, including medical history, medications, and test results, providing them with the information needed to make informed care decisions.  
  • Improved patient engagement: When patients have access to their health records, including test results, medication lists, and appointment schedules, they can take an active role in their healthcare. 
  • Enhanced population health management: With greater insights into population health, providers can better identify and manage patients with chronic conditions, including diabetes and hypertension. This helps providers to target intervention programs, such as health screenings and preventive care services, to specific patient populations, improving health outcomes and reducing the burden on the healthcare system. 

NP Advantage Can Help You Meet Your MIPS Promoting Operability Performance Goals 

NP Advantage can help NPs meet their performance goals, avert penalties, and maximize positive payment adjustments. Our consultants can provide a full practice assessment that will uncover all the ways your teams can improve performance among the MIPS’ categories. Contact us today with questions about how your practice can succeed with MIPS. 

Let’s Improve Patient Care Together