PI Program Scoring Methodology for 2019

In the Fiscal Year (FY) 2019 Inpatient Prospective Payment Systems (IPPS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) finalized a new performance-based scoring methodology for eligible hospitals and critical access hospitals (CAHs) that attest to CMS under the Medicare Promoting Interoperability Program.

As CMS continues to increase program flexibility and decrease reporting burdens, the new scoring methodology is a combination of new and existing measures broken into a smaller set of four objectives:

  • Electronic Prescribing
  • Health Information Exchange
  • Provider to Patient Exchange (formerly known as the Patient Electronic Access to Health Information objective)
  • Public Health and Clinical Data Exchange (formerly known as the Public Health and Clinical Data Registry Reporting objective)

Beginning in 2019, eligible hospitals and CAHs will be required to report certain measures from each of the four objectives with performance-based scoring occurring at the individual measure-level. The scores for each of the individual measures are added together to calculate the total Promoting Interoperability Program score of up to 100 possible points for each eligible hospital or CAH.

Note: The scoring methodology does not apply to Medicaid-only eligible hospitals that submit an attestation to their State Medicaid agency for the Medicaid Promoting Interoperability Program.

For More Information
For additional information regarding the scoring and reporting requirements for 2019, review this Scoring Methodology fact sheet. To learn more about this and other changes finalized in the FY 2019 IPPS Final Rule, review this overview fact sheet and visit the Promoting Interoperability Program website.