Your MACRA Year Two Checklist: Are You Ready?

Last Updated: Apr 4, 2018

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) created the Quality Payment Program (QPP) to change the way the Centers for Medicare and Medicaid Services (CMS) rewards physicians and non-physician practitioners for quality and value over volume.

MACRA-ChecklistAs part of the QPP, eligible clinicians (ECs) can participate in one of two tracks:

  1. Merit-based Incentive Payment system (MIPS) or
  2. Advanced Alternative Payment Models (Advanced APMs)

The goal of these two tracks is to improve beneficiary outcomes, improve data and information sharing, and increase the adoption of Advanced APMs, allowing flexibility for clinicians’ participation.

During 2018, the second year of QPP implementation, most clinicians are expected to participate in MIPS. Check out these steps physicians and practices can take to get ready for MIPS.

 Your MACRA-QPP Year 2 Checklist

Here is a ten-step guide to implement MACRA’s QPP in 2018.
  1. Find Out Whether or Not You Are Required to Participate

    Clinicians must participate if they meet all of the following criteria:

    • Are a physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist.
    • Provide care for more than 200 Medicare patients per year.
    • Bill more than $90,000 in Medicare Part B allowed charge.
    • Not significantly participating in an Advanced APM.

    You don’t need to report in 2018 if it’s your first year participating in Medicare Part B.

  2. Choose a Track


    Cost data will be collected using administrative claims.

    Advanced APM

    • Earn more reward for taking on risk related to patient outcomes.
    • Receive payment based on quality measures comparable to MIPS quality measures.
    • Utilize CEHRT for at least 50 percent of clinicians in the APM entity.

    The list of Advanced APMs is updated annually and can be found here.

  3. Learn about MIPS

    Become familiar with these four performance categories that make up MIPS: Quality, Promoting Interoperability, Improvement Activities, and Cost.

  4. Mips 
  5. CMS offers more details on these performance categories here.

    Select Individual, Group, or Virtual Group Option

    • You can participate in MIPS as an individual, group, or virtual group. 
    • To register as a virtual group, you must have made your election by Dec. 31, 2017.
    • MIPS data submission requires only groups with 25 or more clinicians planning on submitting data using the CMS Web Interface to register on the CMS Enterprise Portal by March 16, 2018.

  6. Make Sure Your EHR Is Certified
    • Your EHR must be certified by the Office of the National Coordinator for Health Information Technology. Use this tool to find out.

  7. Consider Participating in a Qualified Registry or a Qualified Clinical Data Registry (QCDR)
    • These registries collect data from MIPS eligible clinicians, groups, and virtual groups and submit to CMS on their behalf.
    • We have a solution! PAMED’s Care Centered Collaborative has partnered with Mingle Analytics to offer a MIPS reporting solution discounted for PAMED members. Learn more.

  8. Use Your Quality Resource and Use Report (QRUR) to Identify Areas for Improvement
    • This report assesses your performance in quality and cost, as compared to your peers.
    • Feedback on the QRUR will be similar in MIPS. 
    • Authorized representatives of groups and solo practitioners can view their annual QRURs by visiting the CMS Enterprise Portal. Instructions on how to access the report can be found here.
    • PAMED answers member questions on PQRS feedback reports and QRURs.

  9. Select MIPS Measures

  10. Review Workflows to Increase Efficiency

  11. Avoid a Negative Penalty in 2020 by Choosing Your Level of Participation for Performance Year 2018
    • The threshold has been increased to challenge participants to further engage in the QPP. 
    • Ways to achieve 15 points:

 Helpful Links

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