If you’ve asked yourself these questions, you’re not alone.
There’s no avoiding it — MACRA, and the Quality Payment Programs associated with it, are here to stay. Eventually, MACRA will affect your practice’s bottom line.
The Centers for Medicare and Medicaid Services (CMS) has released the Quality Payment Program Year 3 Final Rule Overview. The 2019 Quality Payment Program Final Rule became effective Jan. 1. Under this new rule, CMS uses feedback from the first transition year to continually improve. This gives practices more reporting options and greater flexibility.
The new rule includes these changes:
Updated Merit-based Incentive Program (MIPS) scoring and performance thresholds
Changes to Quality reporting
Higher payment adjustments
Expanded definition of MIPS-eligible clinicians
Two ways to participate
Practices have two options for participating in MACRA. They can report either through MIPS or through an Advanced Alternative Payment Model (APM). Although CMS encourages the latter, that doesn’t mean all practices will be ready. MIPS provides a way for practices to avoid negative payment adjustments and gain incentives, even if they aren’t ready to report right away in 2019.
what is MIPS SCORING IN 2019
The MIPS payment track under MACRA rolls three earlier programs into a single Quality Payment Program (QPP):
Physician Quality Reporting System (PQRS)
Value-based Payment Modifier
Instead of all-or-nothing scoring, MIPS scores practices in four categories:
Here’s what you can expect in these categories:
The Quality category is weighted 45% in Year 3, down from 50% in Year 2.
The Promoting Interoperability category, (formerly Advancing Care Information) remains weighted at 25% in Year 3.
The Improvement Activities category remains weighted 15% in Year 3.
The Cost category is weighted 15% in Year 3, up from 10% in Year 2.
In addition, CMS created an option to use facility-based Quality and Cost scoring for certain facility-based clinicians.
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