The Medicare Access and CHIP Reauthorization Act has propelled the shift already underway in health care - rewarding value over volume.
While the legislation is significant, we believe MACRA doesn't have to be overwhelming.
Here are five reasons why:
The Centers for Medicare and Medicaid (CMS) is increasing opportunities for eligible clinicians (those required to participate in the MACRA Quality Payment Program) to participate in advanced alternative payment models (APMS).
Participating in advanced APMs can either assist clinicians with their score in the Merit-Based Incentive Payment System (MIPS), or exempt them from participating in MIPS.
MIPS consolidates three existing programs- the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and the EHR Incentive Program (Meaningful Use).
If you are doing well under the current Physician Fee Schedule (PFS), you should be positioned well to succeed in MIPS.
The final rule for the MACRA QPP gives eligible clinicians flexibility for the 2017 performance year by providing multiple options for reporting to MIPS.
These options include:
Submit more than 1 clinical performance improvement activity (CPIA), more than 1 Quality Measure (QM), OR more than all 5 required ACI measures for a minimum of 90 continuous days up to a full year to receive a small positive payment adjustment.
Submit at least one QM, at least one CPIA, OR all 5 required ACI measures for a minimum of 90 continuous days up to a full year to avoid a negative payment adjustment.
Join an advanced APM and meet the qualified participant (QP) threshold (via Medicare patient count or payment amount) to be exempt from MIPS.
Submit no data for MIPS and receive the full -4% payment adjustment in the 2019 payment year.
Enjoy the video below to learn more about how to prepare for MIPS in 2017
Now that you have an understanding of what MACRA entails, use the following toolkit to define your plan of action.
Interested in professional services to help assess you MACRA readiness? Let's team up. In our Quality Payment Program (MACRA) Assessment, Cerner Regulatory Experts will provide a detail review of the final rule, assist in determining if you are a Qualified Participant (QP) in an Advanced APM, assess your composite scoring leveraging functional, quality and public data and deliver a strategic action plan.
The Assessment Objectives includes, but is not limited to the following:
Final rule review
Advanced Alternative Payment Options
Composite score modeling
Evaluation of each category (Quality Reporting, Advancing Clinical Information, Resource Use and Clinical Practice Improvement)
Current state gap review in functionality, reporting and governance
Understanding of timelines and financial impacts to the client organization
Understand current state performance in all four categories of MIPS
Following your assessment, Cerner will deliver a customized Strategic Action Plan report to help you navigate whichever path you choose in MACRA. Email us at MACRA@cerner.com today to set a date for your assessment.
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