2018 Promoting Interoperability Transition Objectives and Measures


In 2018 practices are allowed to report using the older objectives and measures that were tied to the modified criteria for Stage 2 Meaningful Use.  Many practices use these measures during the final year of the Meaningful Use of Certified EHR Technology in 2016.  They are referred to as the “2018 Promoting Interoperability Transition Objectives and Measures.”

Since the certification criteria were published in 2014 they are referred to as the 2014 Edition of Certified EHR Technology requirements.  The subsequent certification criteria that was based upon Stage III Meaningful Use objectives and measures was published in 2015, and is referred to as the 2015 Edition of Certified EHR Technology requirements.

This page will review the 2014 Edition objectives, measures and reporting requirements.

Overview of Score Determination for the 2018 Promoting Interoperability Transition Objectives and Measures

Performance in this category for practices using 2014 edition technology is based upon the sum of scores in three areas:

  • Base Score
  • Performance Score
  • Bonus Score

Base Score: 2018 Transition Measures

The base score is determined by performance on four measures:

  • Security Risk Analysis
  • e-Prescribing
  • Provide Patient Access
  • Health Information Exchange

The Security Risk Analysis is reported through attestation only, no data needs to be submitted. The other three measures all have a minimum requirement of one denominator eligible patient where the numerator requirement has also been met.  In other words, if the provider fills one prescription electronically meeting the prescribing requirements during the reporting period the minimum criteria for this measure has been met. The same is true for the Provide Patient Access and Health Information Exchange measures.

As long as these minimum criteria are met the practice will receive a score of 50% of the total Promoting Interoperability score. However, satisfactory reporting all four measures is mandatory. If even one of these measure’s requirements are not satisfied the entire Promoting Interoperability score will be 0%.

Base Measure Exclusions

There are to exclusions available for practices reporting the 2018 Advancing Care Information Transition Objectives and Measures.

  • e-Prescribing measure: MIPS eligible clinicians and groups that write fewer than 100 permissible prescriptions during the performance period may claim an exclusion.
  • Health Information Exchange measure: This exclusion applies to a MIPS eligible clinician or group that transfers a patient to another setting or refers a patient fewer than 100 times during the performance period.

For these exclusion the clinician or group must claim this exclusion when reporting. They should submit a zero for the numerator and denominator for this measure. If the practice qualifies they will still receive a base score.

Performance Score: 2018 Transition Measures

There are a total of 7 performance measures.  Two of the 2018 Transition performance measures (Provide Patient Access and Health Information Exchange) also serve as mandatory base measures.   The measures are:

  • Provide Patient Access – Up to 20 percentage points
  • Health Information Exchange – Up to 20 percentage points
  • View, Download, or Transmit (VDT) – Up to 10 percentage points
  • Patient-Specific Education – Up to 10 percentage points
  • Secure Messaging – Up to 10 percentage points
  • Secure Messaging – Up to 10 percentage points
  • One of the Public Health Reporting Measures – 0 or 10 percentage points

The 2014 Edition Certified EHR Technology will capture all eligible patients and encounters and determine the performance rate which is then reported to CMS (via the EHR, a registry, or attestation).

Scoring criteria for performance measures worth up to 10 percentage points:

Performance Rate >0-10 = 1%
Performance Rate 51-60 = 6%
Performance Rate 11-20 = 2%
Performance Rate 21-30 = 3%
Performance Rate 31-40 = 4%
Performance Rate 41-50 = 5%
Performance Rate 61-70 = 7%
Performance Rate 71-80 = 8%
Performance Rate 81-90 = 9%
Performance Rate 91-100 = 10%

Scoring criteria for performance measures worth up to 20 percentage points:

Performance Rate >0-10 = 2%
Performance Rate 11-20 = 4%
Performance Rate 21-30 = 6%
Performance Rate 31-40 = 8%
Performance Rate 41-50 = 10%
Performance Rate 51-60 = 12%
Performance Rate 61-70 = 14%
Performance Rate 71-80 = 16%
Performance Rate 81-90 = 18%
Performance Rate 91-100 = 20%

Bonus Measures: 2018 Transition Measures

  1. There are two sources of bonus points for practices reporting the 2018 Transition Measures.

Reporting to any one (or more) or the following public health reporting registries (other than one attested for in the performance measure category) will result in a 5 percentage point bonus score:

  • Immunization Registry Reporting
  • Syndromic Surveillance Reporting
  • Specialized Registry Reporting

2. Report one or more specified Improvement Activities using Certified EHR Technology = 10 percentage points