The Medicare Access and CHIP Authorization Act,

(MACRA),has been met with widespread relief and

a tad bit of suspicion. As always conspiracy theories

and unanswered questions are in the air

Here are 10 major questions that everybody wants an answer for…

Taking Action

Here are 10 major questions that everybody wants an answer for.

What exactly is MACRA?

How will MACRA impact payments?

Tell me more about MIPS

1

2

3

Taking Action

Am I eligible to participate in MIPS?

What should I do prepare myself for MIPS?6

Will MACRA eliminate fee for service? 5

What are the data submission requirements of MIPS? 7

4

Taking Action

What should I do prepare myself for MIPS?8

Will MACRA eliminate fee for service? 9

What should I do prepare myself for MIPS?10

What exactly is MACRA?

The Medicare Access and CHIP Authorization Act, (MACRA),

will permanently replace the dreaded Sustainable Growth Rate

formula for determining payments.

MACRA seeks to:

Provide payments based on quality and outcomes rather than volume.

Health information technology will play a major role .

To consolidate major incentive programs like PQRS, value based payment

modifier, Meaningful Use and the Medicare Electronic Health Record incentive

program into one single, comprehensive framework.

#1

How will MACRA impact payments?

There are 2 paths for payment in the MACRA legislation.

The Merit Based Payment System (MIPS)

Alternative Payment Models (APMS)

#2

Tell me more about MIPS

Eligible clinicians will be evaluated based on 4 categories:

Quality- based on the existing PQRS system

Resource use: based on the Value based payment modifier model

Advancing Care Information: which is similar to MU mandates

Clinical practice improvement categories

#3

Am I eligible to participate in MIPS?

You are eligible if you are a physician, registered nurse

practitioner, clinical nurse specialist, certified registered

nurse anaesthetist.

#4

Going forward, the secretary may broaden the eligible clinician group

to make occupational therapists, speech language pathologists and

nutritional professionals to become eligible to participate in MIPS as well.

Will MACRA eliminate fee for service?

MACRA preserves the fee for service model. Physicians who

follow the fee for service model can participate in the

MIPS program.

#5

What are the data submission requirements of MIPS?

MACRA intends to follow a single, unified data submission

method for all the performance categories.

#6

To achieve this goal MIPS expands on the existing quality measures and

simplifies the data submission process.

What should I do to prepare myself for MIPS?

If you are already reporting quality measures under the

existing incentive programs identify and focus on your high

performing quality measures.

Evaluate and educate your staff on QRUR (quality resource and use report) by

CMS and see how improvements can be made .

Analyse your PQRS feedback reports and monitor your current quality metrics

across Medicare and private payers.

#7

What is the Advanced AlternativePayment Model?

AAPMs are performance based payment methods that CMS

will follow to reimburse physicians who care for Medicare

beneficiary. CMS will release a list annually on the care models

that qualify for AAPM incentives.

Providers who participate in qualifying AAPMs will be eligible for APM payments

and bonuses and are exempt from participating in MIPS.

However, all providers will report under MIPS in 2017. CMS will take a decision on the

clinicians who will qualify for APM status.

#8

What are the eligibility criteria for participating in AAPMs?

Providers will have to use certified EHR technology, base

payments on quality measures akin to MIPS and shoulder

monetary risk for financial losses incurred.

Choose quality measures that have a higher chance of success

Identify opportunities to improve patient care and achieve savings for payers

How do I prepare myself to participate in AAPMs?

Implement clinical and financial strategies to help meet your chosen quality measures

#9

#10

Call toll free no 1-888-571-9069

Read More

https://www.billingparadise.com/blog/2016/11/16/macra-faqs/