Care transition documentation practice improvements
Description
Implementation of practices/processes for care transition that include documentation of how a MIPS eligible clinician or group carried out a patient-centered action plan for first 30 days following a discharge (e.g., staff involved, phone calls conducted in support of transition, accompaniments, navigation actions, home visits, patient information access, etc.).
eMeasure ID
First Performance Year
2017
Last Performance Year
Metric Type
boolean
Weight
medium
Sub-category ID
Care Coordination
CEHRT Eligibility
Bonus under ACI
Varidation
Patient-centered, care transition action plan for is carried out for first 30 days following a discharge
Suggested Documentation
Documentation of care transition practices/processes including a patient-centered action plan for first 30 days following a discharge