2021 MIPS IA_EPA_1: Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record

Activity ID

Activity Weighting

Subcategory Name

Expanded Practice Access

Activity Description

Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following:

• Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care);
• Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or
• Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.

Objective

Increase patient access to eligible clinicians who work in an outpatient setting with the goal of reducing unnecessary emergency room visits.

Suggested Documentation

Evidence of demonstrated patient care provided outside of normal business hours through expanded practice hours and by eligible clinicians with real-time access to patient’s electronic health record (EHR), or that patients received needed urgent or transitional care in a timely way. Expanded Business Hours are defined as hours that are outside of a practice’s standard business hours of operation. Include at least one of the following elements:

1) Patient record from EHR – A patient record from an EHR with date and timestamp indicating services provided outside of the practice’s normal business hours for that eligible clinician (a certified EHR may be used for documentation purposes, but is not required unless attesting for the Promoting Interoperability bonus); OR
2) Patient encounter/medical record/claim – Patient encounter/medical record/claim indicating patient was seen or services provided outside of the practice’s normal business hours for that eligible clinician including use of telehealth visits; OR
3) Same or next-day patient encounter/medical record/claim – Patient encounter/medical record/claim indicating patient was seen same-day or next-day by the eligible clinician or practice initially contacted for urgent or transitional care.