The U.S. healthcare system has long struggled with establishing an efficient and effective process for storing and sharing patients’ medical information, but the adoption of the Fast Healthcare Interoperability Resources standard, known as FHIR, is now paving the way for transformative change in this area. FHIR is not only a solution for the seamless exchange of health information but also can alleviate the burden on providers who need to adhere to various quality data reporting mandates. In this article, we'll explain what FHIR is, how it can ease quality data reporting compliance in programs like the Merit-based Payment Incentive System (MIPS) and the Alternative Payment Model Performance Pathway (APP), and what healthcare providers can do today to connect with FHIR.

The Centers for Medicare and Medicaid Services (CMS) Primary Care First (PCF) program is a new alternative payment model designed to support the delivery of advanced primary care. The program began in 2021 and it will examine whether financial risk and performance based payments that reward primary care clinicians will lower Medicare costs and improve health care quality. PCF participants must annually report data on specific quality measures, including the quality measure Advance Care Plan (ACP) which requires a Qualified Registry or QCDR vendor for reporting since it is not an EHR reportable measure. As a CMS Qualified Registry, MDinteractive can support practices participating in the program by reporting this measure on their behalf.

Please note: Cohort 1 practices must report ACP using a Qualified Registry or QCDR for PY 2021; Cohort 1 practices that fail to do so will not be eligible for a positive performance-based adjustment (PBA) in PY 2022.

As we head into the final stretch of Year 2 of the Merit-Based Incentive Payment System (MIPS), clinicians can finally see the finish line approaching for the 2018 performance year. This year MIPS is made up of 4 components: Quality, Promoting Interoperability (formerly ACI), Improvement Activities and Cost. The Quality category accounts for the most at 50% of your total MIPS score. While many clinicians have already collected data throughout the year, it’s not too late to develop a strategy to successfully report Quality and potentially maximize your Medicare reimbursements in 2020.