Medicaid PI Quick Start: HIE Receive and Incorporate

Measure Overview	Medicaid Goal
This measure reports the percentage of visits in which a patient is seen for the first time or referred into the practice and the receiving provider incorporates an electronic summary of care document/continuity of care document (CCD) from the referring provider into the patient’s chart.	Must Exceed 40%

Setup Requirements
This measure requires the following setup: The Reference Documents Section must be added to the Facesheet. The method by which your organization will import CCDs must be configured. Users must have the Reconcile Reference Documents user right.

Setup Requirements

This measure requires the following setup:

Denominator
For a visit to qualify for the denominator, both of the following are required: The patient must have a visit during the measurement period indicated by either of the following: The Plan or E&M section of the Note includes a new patient E&M code in the range of 99201-99205 or 99381-99387 added at the same time or after the start of the visit. The Inbound Referral/Transition check box is selected under Referrals in the Plan section of the Note at the same time or after the start of the visit. A summary of care document was received or is available. This document must be linked to the patient's qualifying visit. This can be indicated by either of the following: The Outside summary of care available check box is selected under Referrals in the Plan section of the Note. A summary of care document/CCD was imported into the Reference Documents section on the patient’s Facesheet during the measurement period but before the end of the visit.

Denominator

For a visit to qualify for the denominator, both of the following are required:

The patient must have a visit during the measurement period indicated by either of the following:
The Plan or E&M section of the Note includes a new patient E&M code in the range of 99201-99205 or 99381-99387 added at the same time or after the start of the visit.
The Inbound Referral/Transition check box is selected under Referrals in the Plan section of the Note at the same time or after the start of the visit.
A summary of care document was received or is available. This document must be linked to the patient's qualifying visit. This can be indicated by either of the following:
The Outside summary of care available check box is selected under Referrals in the Plan section of the Note.
A summary of care document/CCD was imported into the Reference Documents section on the patient’s Facesheet during the measurement period but before the end of the visit.

Numerator
Visits with all the following completed during the calendar year the measurement period begins in: The CCD is in the Reference Documents section of the patient’s Facesheet. If using an outside summary of care document, you must import the document prior to reconciling. The document’s data was either reconciled or acknowledged after the start of the visit but during the calendar year. When reconciling, you must have the qualifying visit selected in the top left of Prime Suite for the reconciliation to be associated with the visit. The provider that acknowledges the document must be the same as the provider on the visit. The document was linked to the qualifying visit when acknowledging or automatically reconciling the data.

Numerator

Visits with all the following completed during the calendar year the measurement period begins in:

The CCD is in the Reference Documents section of the patient’s Facesheet. If using an outside summary of care document, you must import the document prior to reconciling.
The document’s data was either reconciled or acknowledged after the start of the visit but during the calendar year.
When reconciling, you must have the qualifying visit selected in the top left of Prime Suite for the reconciliation to be associated with the visit.
The provider that acknowledges the document must be the same as the provider on the visit.
The document was linked to the qualifying visit when acknowledging or automatically reconciling the data.