MACRA, the Medicare Access and CHIP Re-Authorization Act, is sweeping legislation enacted in April 2015. MACRA repeals the Sustainable Growth Rate (SGR) formula originally enacted in 1997. To control the growth of Medicare costs, SGR is replaced by value-based reimbursement programs. These value-based reimbursement programs include Alternative Payment Models (APMs) such as Accountable Care Organizations (ACOs), Patient Centered Medical Homes (PCMHs) and others. For physicians and other providers who do not participate in an APM, the Merit-Based Incentive Payment System (MIPS) will reward providers who deliver high-value care while penalizing those who provide low-value care.
During 2018, CMS has classified six of the MIPS quality measures “topped out” which makes achieving a high final score a bit tougher. In subsequent years, more measures will become topped out so providers will need to identify new measures in order to achieve the same MIPS final score.Read More
The Security Risk Analysis (SRA) remains a requirement for the new Advancing Care Information (ACI) category of MIPS. A change enacted this year requires that the SRA be complete by 12/31/2017 under ACI, the Medicaid Meaningful Use program for physicians, and Hospital Meaningful Use programs. Practices who need outside help are advised to schedule their early to ensure that it is completed on time, and to avoidRead More
While most of the political attention has focused on the GOP and Trump administration’s efforts to repeal Obamacare, aging Baby Boomers continue to challenge the finances of Medicare and the entire U.S. Federal budget. After the recent passage of an Obamacare repeal bill in the House, it is likely that political attention will remain on Obamacare repeal efforts, leaving recently enacted programs affecting Medicare, MACRA and MIPS, intact. It is possible that practices who maximize their performance under MIPS could earn a big payday, as high asRead More
The Quality Payment Program final rule has been released. What payment adjustments will physicians see in the upcoming years? How quickly will the new payment methodologies be implemented?Read More