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Your MACRA Checklist: Are You Ready for Implementation in 2017?

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 is a new law that will gradually change the way physicians are paid under Medicare. The law calls for the creation of a Quality Payment Program consisting of two tracks:

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

During the first year of MACRA implementation in 2017, most physicians are expected to participate in MIPS. Check out these steps physicians and practices can take to get ready for MIPS in the infographic below:

 

 

Here are more details to the checklist.

Find out whether you are required to participate. You participate in the Quality Payment Program if you bill Medicare Part B more than $30,000 in allowed charges per year, provide care for more than 100 Medicare patients per year, and are one of the following: physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist. You don’t need to report in 2017 if it is your first year participating in Medicare Part B, or if you significantly participate in an Advanced APM.

  

Avoid a negative penalty in 2017 by choosing your participation option. These four participation options are available for 2017: test the Quality Payment Program by submitting some data, participate for part of the 2017 calendar year, participate for the full 2017 calendar year, or participate in an Advanced APM. Learn more here.

Important Note: You will be subject to a negative four percent payment adjustment If you are eligible for participation but choose not to participate in MIPS or an Advanced APM in 2017. Participating using the “Test the Quality Payment Program” option is simple: Physicians and practices can avoid the four percent penalty by reporting at least one measure for one patient.

  

Learn more about MIPS and its performance categories:

  • Quality—Replaces the Physician Quality Reporting System (PQRS); Scoring weight for 2017: 60 percent

  • Advancing Care Information—Replaces Meaningful Use; Scoring weight for 2017: 25 percent

  • Improvement Activities—A new category; Scoring weight for 2017: 15 percent

  • Cost—Replaces Value-Based Payment Modifier; Scoring weight for 2017: not weighted

CMS offers more details here.

  

Decide if you’re participating in MIPS as an individual or as a group. The deadline for registering to report as a group is June 30, 2017. CMS' “Get Prepared” page has details.

  

Make sure your EHR is certified by the Office of the National Coordinator for Health Information Technology. Use this tool to find out.

  

Use Your Quality Resource and Use Report (QRUR) to identify areas for improvement. The Pennsylvania Medical Society (PAMED) hosted a QRUR Workshop, and several resources highlighted during the workshop are available here.

  

Consider participating in a qualified clinical data registry.

  

Explore the MIPS measures. CMS offers tools you can use to select your MIPS measures:

  

Review workflows to increase efficiency. Check out PAMED’s “Embracing the Benefits of Workflow Analysis” for details.

 

More Resources

PAMED will continue to update our MACRA webpage with news and updates. Members are encouraged to visit www.pamedsoc.org/macra frequently. Members with questions can also contact our Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.


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