HHS establishes two metrics to evaluate ‘widespread interoperability’ under MACRA       

Computer made humans standing in a circle

The Office of the National Coordinator for Health IT will use two metrics to measure interoperability of health information as required by the Medicare Access and CHIP Reauthorization Act (MACRA).

MACRA required the Health and Human Services Department to establish metrics to determine if the extent of “widespread interoperability” by July 1. ONC announced that day it chose two measures that are the most appropriate to fulfill the MACRA requirement:

  • The proportion of providers who are electronically engaging in the following core domains of interoperable exchange: sending, receiving, finding (querying) and integrating information from outside sources
  • The proportion of providers who report using the information they electronically receive from outside providers and sources for clinical decision making.

ONC will use national representative provider surveys to obtain the metrics and evaluate progress. 


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The office had received nearly 100 comments regarding how the government should measure interoperability. The comments focused mainly on four issues: the reporting burden on providers; whether the scope should be broad enough to include providers not in the incentive programs; that the measurement should go beyond the exchange of information and also examine the usability and usefulness of the information; and the need to recognize the complexity of measuring interoperability fully.

In a related blog post, published July 1, Seth Pazinski, director of ONC’s Office of Planning, Evaluation and Analysis, and Talisha Searcy, the office’s director of research and evaluation, said the measures satisfy the feedback received and MACRA’s specific parameters. They also noted that while MACRA focuses on “meaningful users,” ONC is committed to advancing interoperability more broadly; it will expand the measurement efforts to other providers and will eventually include measurements involving outcomes.

“We look forward to engaging with stakeholders from across the health IT landscape in further depth on these efforts to provide insight into the nation’s progress in ensuring that health data will flow seamlessly and securely where and when it is needed,” wrote Pazkinski and Searcy.

If HHS determines that widespread interoperability is not met by Dec. 31, 2018, it will submit a report to Congress by Dec. 31, 2019 on the barriers to interoperability and recommendations regarding how to achieve it.

To learn more:
- here’s the explanation
- read the blog post

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