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MACRA Quality Payment Program Resources

 

MACRA

Prepare your practice for Quality Payment Programs

 

What is MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years.

If you participate in Medicare Part B, you are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans. The Quality Payment Program’s purpose is to provide new tools and resources to help you give your patients the best possible care. You can choose how you want to participate based on your practice size, specialty, location, or patient population.

The Quality Payment Program has two tracks you can choose:

  • Advanced Alternative Payment Models (APMs) or
  • The Merit-based Incentive Payment System (MIPS)
What is MACRA?

MIPS Performance Categories

MIPS Quality Category

Quality

This performance category replaces PQRS. This category covers the quality of the care you deliver, based on performance measures created by CMS, as well as medical professional and stakeholder groups. You pick the six measures of performance that best fit your practice.

MIPS Promoting Interoperability Category

Promoting Interoperability

CMS is re-naming the Advancing Care Information performance category to Promoting Interoperability (PI) to focus on patient engagement and the electronic exchange of health information using certified electronic health record technology (CEHRT). This performance category replaced the Medicare EHR Incentive Program for EPs, commonly known as Meaningful Use. This is done by proactively sharing information with other clinicians or the patient in a comprehensive manner. This may include: sharing test results, visit summaries, and therapeutic plans with the patient and other facilities to coordinate care.

MIPS Cost Category

Cost

This performance category replaces the VBM. The cost of the care you provide will be calculated by CMS based on your Medicare claims. MIPS uses cost measures to gauge the total cost of care during the year or during a hospital stay. Beginning in 2018, this performance category will count towards your MIPS final score.

MIPS Improvement Activities Category

Improvement Activities

This is a new performance category that includes an inventory of activities that assess how you improve your care processes, enhance patient engagement in care, and increase access to care. The inventory allows you choose the activities appropriate to your practice from categories such as, enhancing care coordination, patient and clinician shared decision-making, and expansion of practice access. 

MIPS Timeline and Important Deadlines

  • January 1, 2018: Performance Year (PY) 2018 Begins

 

  • August 1, 2018: ACI Hardship Exception Application Window Opens

If you seek hardship exception to the advancing care information category, you will be able to apply for this between August 1, 2018 and December 31, 2018.  

 

  • December 31, 2018: ACI Hardship Exception Application Window Closes

 

  • January 1, 2019: Performance Year 2017 Payment Adjustment

The first payment adjustments based on Performance Year 2017 go into affect on January 1, 2019.

  • January 2, 2019: Submission Window Opens for Performance Year 2018

You may submit and update your data any time while the submission window is open.

 

  • January 2019: CMS Web Interface Submission Period Begins for PY 2018 

Registered groups may submit group data in the CMS Web Interface during the 8 week submission window.

 

  • March 2019: CMS Web Interface Submission Window Ends for PY 2018

 

  • April 2, 2019: Submission Window Closes for Performance Year 2018

You may submit and update your data any time while the submission window is open.

VIEW ALL DEADLINES

A Beginner's Guide to MIPS

An Intro Into How to Participate

Not sure where to start? Download our free beginner's guide to learn the basics of the Merit-based Incentive Payment System.

In this guide you will learn:

  • How to check participation status
  • Steps to take for long term success with MIPS
  • An overview of each reporting option

{+} Click Here to Download Now

A Beginner's Guide to MIPS
eClinicalWorks MIPS Dashboard

An Integrated MIPS Dashboard to Manage Participation

With eClinicalWorks, practices can track provider participation in the Merit-based Incentive Payment System across MIPS measures. The eCW MIPS dashboard provides multiple views of data on the provider and practice level.

eClinicalWorks V11 is the next step in the evolution of healthcare IT, a cloud-based EHR and Revenue Cycle Management solution designed to meet the challenges and opportunities of value-based care. As a 2015 Edition certified product under the ONC Health IT Certification Program, eClinicalWorks V11 can assist your practice in participating in the Quality Payment Programs. Schedule your demo today to learn more. 

*Disclaimer: Dates and content on this page were up to date at the time of creation. Please refer to the CMS Quality Payment Program website to ensure no changes have taken place to MIPS program.

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