ACMSS Helps Practices with MACRA’s Advancing Care Information Category

Since the recent implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) Quality Payment Program (QPP), ACMSS has been studying nearly 2,400-page document in order to help clinicians and practices get ready for the first reporting period, which began on Jan. 1, 2017 and closes Dec. 31, 2017. To avoid penalties, eligible clinicians should plan to report some data to the Centers for Medicare and Medicaid Services (CMS) in 2017. Whether you choose to report only 90 days of data or the entire year, you need to do some planning.

In this article we will talk about some of the ways that Certified Medical Scribe Specialists (CMSS) and ACMSS can help providers report one of the key categories— Advancing Care Information—which is weighted at 25% of QPP consideration. Advancing Care Information replaces the Medicare EHR incentive program formerly referred to as Meaningful Use of Computerized Provider Order Entry (CPOE), or simply Meaningful Use.

In this category, to potentially earn a positive payment adjustment beginning on Jan. 1, 2019 under the Merit-based Incentive Program (MIPS), clinicians must send in data to MIPS about how their practices used technology in 2017 by the deadline of March 31, 2018. (Those who are using an Advanced Alternative Payment Model, or APM, will report through that model by the same date and may earn a 5% incentive payment in 2019.) There may be some crossover in reporting on this category for the Clinical Improvement category, and bonus credit may be available for reporting in both.

For full participation in the advancing care information performance category, MIPS eligible clinicians will report on five required measures. These measure are shown below along with an explanation of how ACMSS and Certified Medical Scribe Specialists can help eligible clinicians meet some of these requirements.

  • Security Risk Analysis
    Reporting Measure: Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician’s risk management process.

    How we can help: Certified Medical Scribe Specialists all have standardized packages and security protections of membership, including HIPAA for Scribes customized video/certificate assessment, Medical Scribe Certification Aptitude Test (MSCAT) Training/Resource Manual and MSCAT Certification.

  • e-Prescribing
    Reporting Measure: At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

    How we can help: The ACMSS CMS-approved credential crosswalk includes advanced clinical and non-clinical skill sets that include workflow enhancements of computerized provider order entry, preparing clinical procedure trays, assisting patients and much more.

  • Provide Patient Access
    Reporting Measure: For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician ensures the patient’s health information is available for the patient (or patient-authorized representative) to access using any application of their choice that is configured to meet the technical specifications of the Application Programing Interface (API) in the MIPS eligible clinician’s certified EHR technology.

    How we can help: Entering certified electronic health record technology (CEHRT) requirements through CMS-recognized attested CEHRT personnel, minimum clinical information is captured in writing the patient’s narratives toward wellness. Clinical outcomes are produced through alignment of richly embedded narrative that extends beyond the pick lists and minimum data detail to produce patient-centered advanced care and outcomes. Physician/CMSS teams may assist with research, patient education and information dissemination, in addition to workflow and highly advanced clinical/non-clinical skill sets and roles found in these hybrid teams, allowing physicians to innovate care and create new holistic models of care with the assistance of ACMSS.

  • Send Summary of Care
    Reporting Measure: For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider-(1) creates a summary of care record using certified EHR technology; and (2) electronically exchanges the summary of care record.

  • Request/Accept Summary of Care
    Reporting Measure: For at least one transition of care or referral received or patient encounter in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician receives or retrieves and incorporates into the patient’s record an electronic summary of care document.

    How we can help: Certified Medical Scribe Specialists can assist with many tasks, including assisting with insurance documentation, research, patient education, and ensuring an effectively documented CEHRT. Minimum CMS requirements enable a natural conduit to public healthcare reform through wellness-driven initiatives.

Additional Measures
Eligible clinicians can choose to submit up to 9 measures for a minimum of 90 days for additional credit. For bonus credit, you can report public health and clinical data registry reporting measures, and/or use certified EHR technology to complete certain improvement activities in the improvement activities performance category. (We will address this category in an article next week.)

Other measures under Advancing Care Information (Option 1) include:

  • Clinical Data Registry Reporting
  • Clinical Information Reconciliation
  • Electronic Case Reporting
  • Immunization Registry Reporting
  • Patient-Generated Health Data
  • Patient-Specific Education
  • Provide Patient Access
  • Public Health Registry Reporting
  • Secure Messaging
  • Syndromic Surveillance Reporting
  • View, Download and Transmit (VDT)

For more details on the Quality Payment Program, click here (https://qpp.cms.gov)

In 2017, there are two measure set options for reporting. The option you use to submit your data is based on your electronic health record edition.

  • Option 1: Advancing Care Information Objectives and Measures
  • Option 2: 2017 Advancing Care Information Transition Objectives and Measures

For more information about Advancing Care Information and to identify your EHR edition, go to https://qpp.cms.gov/measures/aci

Using medical scribe specialists can help alleviate some of the very real sources of clinician dissatisfaction in our healthcare system today and help them meet MACRA QPP goals. The practice efficiencies that medical scribe specialists provide have been shown to ease the clerical burdens of electronic health records, and give physicians back the time and attention they need to focus on their patients.

A Certified Medical Scribe Specialist serves as an assistant to the physician and/or mid-level provider, and can help to to maximize the efficiency and productivity of clinical care. Their traditional duties include real time transcribing of physician notes, organizing objective health care data, and enhancing the electronic health record, point-of-service collections, and patient tracking. Nowadays, the role of a Certified Medical Scribe Specialist are going far beyond those traditional duties.

With the new Medical Scribe Specialist Curriculum, approved earlier this month, the role of the medical scribe specialist has been greatly expanded. The new guidelines go into far more detail than the 2015 version, including delving into national standards such as the Medicare Access and CHIP Reauthorization ACT (MACRA) and its Merit-Based Incentive Payment System (MIPS), and the Health Information Technology for Economic and Clinical Health (HITECH) Act. They also focus sharply on employing medical scribe specialists in roles related to wellness, prevention, integrative care, and complementary and alternative medicine.

Physician/CMSS teams operate under the physician license to enhance workflow, patient efficiencies, patient-centered care, and focus on holistic wellness-driven care. For information on how our “CMSS Direct” Clinical Corporate Partner is using Physician/Certified Medical Scribe Specialists Teams to streamline operations and improve care, go to https://theacmss.org/citymdclinicalpartner/

The ACMSS certification program meets current and proposed CMS certification requirements toward meaningful use of electronic health records. ACMSS is independent from all scribe companies and organizations and works in compliance with the Centers for Medicare and Medicaid Services to meet national goals and initiatives of MIPS, MACRA, and Meaningful Use of computerized provider order entry. Certified medical scribes also meet the “qualified people” standard in Certified Electronic Health Record Technology (CEHRT).

The American College of Medical Scribe Specialists offers several pathways for Certified Medical Scribe Specialists and a growing list of customized, one-on-one consulting solutions. Please contact ACMSS directly at info@theacmss.org or 657-888-2158 if you have any questions regarding the ACMSS program and consulting services.