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MACRA & MIPS

Are you ready for MIPS?.

Understand MACRA/MIPS.

What Is MACRA?

Starting in 2017, Medical providers will have to participate in either the Merit Based Incentive Payments System (MIPS), Alternative Payment Models (APMs), or Advanced Alternative Payment Models 

Merit-Based Incentive Payment System (MIPS)

Most provders will be subject to MIPS program

Alternative Payment Models (APMs) 

APMs, or Alternative Payment Models, provide additional incentives to practices willing to adopt additional risk and meet certain conditions.

Advanced Alternative Payment Models

The most advanced alternative payment models will be deemed ‘eligible’ APMs which qualify for even higher levels of reimbursement tied to performance. These will be a subset of APMs and will not include all payment models. 

 

How Does MIPS Work?

You earn a payment adjustment based on evidence-based and practice-specific quality data. You show you provided high quality, efficient care supported by technology by sending in information in the following categories.

Quality

This replaces old PQRS.

Improvement Activities

New Category.

EHR

Advancing Care Information

Replaces the Medicare EHR Incentive Program also known as Meaningful Use.

 

Cost

Replaces the Value-Based Modifier.

2017 MIPS Performance

Quality: 60%

Report up to six quality measures, including an outcome measure, for a minimum of 90 days.

Advancing Care Information (ACI): 25%

Fulfill five (5) required measures for a minimum of 90 days.

Report up to nine additional measures for minimum of 90 days for additional credit.

Improvement Activities: 15%

Attest to completing up to four (4) activities for at least 90 days.

Groups with fewer than 15 participants or in a rural or health professional shortage area attest to completing up to two (2) activities for a minimum of 90 days.

Cost Resource Use: 0%

CMS will calculate these measures based on adjudicated claims.

Reward/Penalty

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EHR, Practice Management, Billing Solution, Patient Portal and Self Check-In Kiosk. 

 

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