MACRA’s Paths: MIPS and APMs
The following programs as we know them have ended, have been repackaged, and rolled into MACRA/MIPS:
• Meaningful Use
• Value-Based Modifier
• Physician Quality Reporting System
MIPS Performance Categories
The four performance categories that will make up MIPS participants’ total score are as follows:
Advancing Care Information: 25%
Clinical Practice Improvement: 15%
Resource Use/Cost: 0% (No reporting is required for this. It’s calculated from adjudicated claims.)
Remember: Unlike old programs (such as PQRS), which worked similarly to a “pass/fail” grading system, MIPS providers are “graded” on a curve.
Flexibility: For the first reporting period 2017
CMS has declared 2017 as a transition year for MACRA. Providers who qualify for MIPS can “pick their pace.” MediTouch software will allow each provider to choose their reporting period for the year.
Full year: Prepared? Report a full calendar year of data; possible full bonus.
Partial year: Somewhat prepared? Report all requirements for less than a year; possible smaller bonus
Report anything: Not prepared? Report any data for less than a year; no penalty, no bonus.
* Report nothing in the first year of MACRA will receive a -4% penalty.
How Will the Payment Adjustments Work?
In the first year of MACRA, 2017: A provider who chooses to report for the full calendar year has the *potential to earn up to 4% positive payment adjustment, depending on how high above the bell curve he or she lands. Those providers who perform as “A” students on the curve “could” receive a “modest” payment adjustment. The very few who perform as Valedictorians have the potential to receive up to a 12% positive payment adjustment in the first year. Payment adjustments increase with each year until 2020 and beyond.
How Can MediTouch Help You?
- Easily accessible dashboards for physician performance
- Automated quick actions to improve score of entire population
- Easy comparison of provider performance across practice
- Detailed views and patient summaries for quick action to improve scores
- Track performance on selected measures and report on top CQM
- Automated reporting for easy submissions to CMS
- Detailed training modules and customer support on all aspects of MACRA