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Renae Rossow
Renae Rossow
Understanding MACRA and the Quality Payment Program Part 10

Understanding MACRA and the Quality Payment Program Part 10

By now you should have a good grasp of what MACRA and the Quality Payment Program mean for your practice moving forward. If you’ve been following this series from the beginning, you should know which payment track you’ll be on in 2017, MIPS or APMs, and you should understand the requirements that track will have for you to achieve success. Today we’ll take a final look at MACRA and some of the items you will need to keep an eye out for in the coming year. 

MIPS Overview

If you’re in the MIPS Payment Track of the QPP, remember that there are 3 options for avoiding a negative payment adjustment altogether. Those options are:  1) Report some data for 1 quality measure or 1 improvement activity or meet the reporting requirements of the Advancing Care Information Category; 2) Report 90 consecutive days of data occurring 2017 for the Quality, Improvement Activities, and Advancing Care Information categories; and 3) Report a full year’s data for 2017 for the Quality, Improvement Activities, and Advancing Care Information categories. By choosing any of these options, you will avoid the negative payment adjustment. By choosing option 2 or 3, you will receive some type of positive payment adjustment and even have the potential of achieving a bonus payment. 

APMs Overview

If you are in the APMs track, your office would have already notified you in writing of your status as a qualified participant. Additionally, you would have already been participating in one of the Advanced APMs before January 1, 2017. If you want to be able to migrate over from the MIPS Payment track to the APMs payment track you would need to begin participating in one of the seven current models available. You can find that list by reading Part 8 of this series.    

Changes Are Coming

With the release of the Final Rule, there were significant changes to MACRA – most that affected the first performance year, 2017. Things like the “pick-your-pace” approach for those in the MIPS track reduced the stress level significantly. They also changed the low-volume performance threshold so that anyone who received $30,000 or less in Medicare payments or saw equal or less than 100 Medicare patients were excused altogether from participating in the Quality Payment Program. 

The future will bring more changes with it. We know that the list of eligible clinicians will grow to include physical and occupational therapists, nutritionists, and clinical social works. However, we don’t know the exact timing of their inclusion. Additionally, everyone will need to begin collecting data for the full year and for all four categories. Once again, whether that will be added back in for the 2018 Performance year remains to be seen. CMS has also been very clear that they want more practices to participate in Advanced APMs and they fully intend to continue adding to that list with each passing year. We also know there will be things like virtual groups introduced to MACRA participants making it possible for individual physicians to achieve better scoring and encouraging providers to participate in Advanced APMs. 

In short, your best approach to being successful with MACRA and the Quality Payment Program will be to do your best during the current performance year and always keep your eyes peeled for the inevitable changes that will come with each passing year. It’s going to take a little time to turn the Titanic around.

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