The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Sustainable Growth Rate and introduced the Quality Payment Program, which seeks to encourage clinicians to provide more comprehensive care through two tracks: The Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). CMS finalized the 2017 regulation in October 2016 through overwhelming bipartisan support. A new proposed rule for 2018 is due to finalize by Nov. 1, 2017.
MIPS is the combination of the former Physician Quality Reporting System (PQRS), Meaningful Use (MU), and the Value-based Modifier, which had their final performance periods in 2016. It also incorporates a new element called Clinical Practice Improvement Activities. Each year, providers will receive payment adjustments based on their performance in four categories, which could be an incentive or penalty — in 2017, up to 4%.
MIPS is composed of four scoring categories:
Participation in Advanced APMs exempts a provider or group from MIPS reporting and payment adjustments. These are value-based contracts that include an element of financial risk, such as shared losses. CMS desires to encourage more providers to participate in this track. In 2017, Medicare Shared Savings Program tracks 2 and 3, Comprehensive Primary Care Plus (CPC+), and Next Generation Accountable Care Organizations (ACOs) are all included.
The rule will continue to evolve over time. We’ve already seen increased flexibility in reporting options in the most recent update, and expect to see more measures around interoperability and patient engagement in the future. To get started, be sure to check out these resources:
Advancing Care Information makes up a significant portion of your MIPS score. Learn how you can meet your measures, avoid a financial penalty, and maybe even gain an incentive in this informative webinar.
How will CMS score your practice on Quality and Cost? This webinar dives into two of the four MIPS scoring categories and helps you understand how to meet your measures.
What are Clinical Practice Improvement Activities, and how can you meet your objectives this year? Get insights into this MIPS scoring category in this webinar.
The Merit-based Incentive Payment System (MIPS) is only one option under MACRA. High-performing practices may want to consider the alternative: Advanced Alternative Payment Models (APMs). Learn more in this webinar.
Learn what’s in the new proposed MACRA rule and how it may impact your practice in 2018 and beyond.
Download this informative ebook for a deep dive into this year’s proposed rule for MACRA. Explore MIPS and Advanced APMs, and get a better understanding of the right path for your practice.
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