yes no tickbox with green yes tick

MIPS: Health Information Exchange (HIE) Bi-Directional Exchange (PI_HIE_5)

Are you ready to attest Yes?

All Medicare providers have been grabbling with MACRA/MIPS (Merit Based Incentive Payment System) since 2017.  Traditional MIPS is the original framework for collecting and reporting data to CMS, which provided for certain types of reporting exclusion in the beginning.  But as the program has matured, we have also seen requirements change each Performance Year (PY), and certain reporting, you may have had the ability to exclude certain reporting measures like interoperability, but for the PY 2022 that is no longer the case which leads me to believe a quick recap might be helpful for some of our readers.

Brief History:

Prior to 2021 MIPS eligible providers were required to report on two measures under the MIPS Promoting Interoperability category (PI_HIE_1 and PI_HIE_4) which forced many clinicians and groups to adopt clumsy, click heavy, workflows in an effort to ‘close the loop’ on their patient referrals. This not only added an extra burden on already over stretched healthcare workers, but hindered, rather than improved, the desired result in better access to patient records at point of care as intended.

The Big Change:

When the 2021 MIPS requirements were released by the Centers for Medicare and Medicaid Services (CMS) there was a new 3rd measure added as an OR option to the above two measures. This new measure (PI_HIE_5) allows MIPS eligible clinicians or groups to simply attest yes IF they participate and bi-directionally exchange data through a health information exchange (HIE).

Centralis Health has been exchanging clinical healthcare data regionally for over a decade and a half, but when PI_HIE_5 was released as option we knew we needed to expand our network to assist our healthcare participants in attesting Yes to this new measure. In October of 2020 we became the first vendor participant on the national eHealth Exchange (eHX) and seemingly overnight expanded our data exchange reach to an additional 366 healthcare organizations across the nation and locally (and growing). Now in April of 2022, we are proud to say we are not only helping participants ‘check the box’ for PI_HIE_5, but we are also operationalizing the data exchange and helping our participants search, retrieve, and absorb healthcare data that previously would not have been available to them without a phone call or a fax.

I commend CMS for the addition of this new measure as it genuinely speaks to the true nature of data sharing and health information exchange that I believe PI_HIE_1 and 4 were lacking. Clinicians and groups who attest Yes to PI_HIE_5 will now be able to establish referral workflows and solutions that work for them and don’t just check a box. It isn’t very often in healthcare that you are gitty about a policy change, but I’m gitty about this one and the doors it will open for the better exchange of data and more available records at point of care.

by Katie Bradley, Director of Operations and Account Success

As Director of Operations and Workflow, Bradley is responsible for helping hospitals and medical practitioners transition from their outdated and manual health care communications workflows and processes to embrace Centralis Health’s innovative and cloud-based solutions. This includes transforming existing fax, internal communications, and referral management processes to achieve maximum efficiency, productivity, and cost savings. In addition, Bradley leads efforts to encourage and engage greater community participation in health care exchanges between providers and hospitals. Prior to joining Centralis Health in 2015, Bradley served in a variety of administrative and operations roles in health care, including as Director of Operations for Digestive Disease Clinic in Tallahassee, FL. She graduated summa cum laude from Florida International University with a Bachelor of Science degree in Health Services Administration. In her free time, she enjoys traveling and spending time with family and friends.