Here is what the AAFP has to say about MACRA

As if Meaningful Use and PQRS  weren't difficult enough, now it's the MACRA ruling. Medical practices need to implement this complex mandate, or like PQRS and Meaningful Use, there will be penalties in the future.

We have the solution!

How does our MACRA program differ from others?

  • Our system reports on over 60 measures, whereas most others report on 20-30 measures
  • Our system integrates with nearly all of the major EHR systems to AUTOMATICALLY pull diagnosis codes and other necessary information
  • There is no set-up cost for physicians or practices
  • Our program is likely to have the greatest increase in reimbursement to physicians with little or no direct time commitment
  • Our program offers an end of the year report at no charge to submit as required
  • Our program has extremely competitive fees that is less than most programs
  • We can get you online in as little as 7 days.

TERMS

  • MACRA: Merit-Based Access and CHIP Reauthorization Act
  • MIPS: Merit-Based Incentive Payment System
  • APM: Alternative Payment Model
  • QPP: Quality Payment Program
  • EC: Eligible Clinician
  • CPS: Composite Performance Score
  • MU: Meaningful Use
  • PQRS: Physician Quality Reporting System
  • VM: Value-Based Payment Modifier Program

 

STEP 1: Prepare Now

Preparations began in November 2016 and Implementation begins in January 2017

STEP 2: Choose one of two payment systems

  1. MIPS (MU, PQRS, VM): A combination of 3 programs that give scores physicians based on the performance on 4 areas that affects Medicare reimbursements.
  2. APMs include organizations that evaluates quality of care and cost using models such as Next Generation ACOs and Comprehensive Primary Care Plus

STEP 3: Report for 2017

In 2017, everyone reports under MIPS, unless they are new to Medicare or have a very low Medicare volume within their practice (providers with less than 100 total Medicare patients or less $30,000/year billed to Medicare). The reporting period is a full 12 months--not 90 days. CMS will evaluate this data and determine which clinicians qualify for APM reporting. Performance data will be used to adjust Medicare payments in 2019.

We have the solution!

 

What should most clinicians expect?

Under MIPS, it is expected that most clinicians will see an adjustment of income--either up or down. The majority of independent practices are expected to see a decrease in reimbursements.

How do I report for MIPS?

There are several programs out there, all of whom do not offer every reporting measure that is available. Even the EHR "giants" in the industry offer little reporting options. In short, a better reporting program means more reimbursement and choosing the wrong program can cost even a 5-provider practice over $100,000 of lost revenues, so choose carefully!

Did MU go away?

Medicaid providers who also provide care for Medicare must still report MU through 2021 in addition to MIPS.

What will else will be done with my score?

MACRA requires that a provider's MIPS score, in addition to the score of each of the four performance categories, be posted to the Physician Compare website. Providers who choose NOT to report will be reported as well. Therefore it is essential for providers to participate as prospective patients will have access to 2017 scores.

What cuts or bonuses have been seen and can I expect?

PQRS cuts can be as much as 13% in 2015. Meaningful Use penalties penalties can be as much as $35,000 for a 5 doctor practice.. For PQRS, penalties can be as much as $35,000 for a 5 doctor practice, although successful practices can see as much as a $130,000 increase.

  • Chronic Care Management: non-face-to-face services for patients with 2 or more chronic illnesses can see as much as $100,000 in additional revenues for a 5 physician practice
  • Transitional Care Management Program: up to $120,000 for aiding in the transition from Provider to Provider in a 5 physician practice.

 

MACRA - lecture by Dr. Rose

The time to act is NOW!

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