Questions about MACRA? Ask an AAD expert


If you have a question about how MACRA will impact you and what you should do to prepare, submit it to the Academy’s MACRA Community, and AAD expert staff will get you an answer. Below is a question and answer from the AAD's MACRA Community.

Q: To say all the measure descriptions are a little confusing is an understatement. The quality measures are pretty straightforward as we have used these in the past with PQRS, but the practice improvement measures are a bit confusing, do you have any examples of some of these measures that would pertain to a dermatology practice?

Since we do not have an EHR, is there anything we can do to meet any of the advancing care information measures?

-Submitted by Christine M Liles, CPC

A: You can't perform the ACI measures without a certified EHR. For a list of dermatology-specific practice improvement activities, visit

For the practice improvement activities, CMS has left the definitions vague so physicians can perform a multitude of activities to qualify. One example would be for the following practice improvement activity:

Participation in a QCDR, clinical data registries, or other registries run by other government agencies such as FDA, or private entities such as a hospital or medical or surgical society. Activity must include use of QCDR data for quality improvement (e.g., comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcome).

You could participate with AAD's DataDerm, which is expected to be approved as a QCDR by CMS in the Spring, and report quality measures whereby you would receive feedback on how you are performing. Your improvement activity would then be increasing your performance through the use of quality improvement tools which will be available through DataDerm.

-Answer provided by Rachna Chaudhari, AAD Senior Manager, Practice Management Resources

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