Incentives The March to MACRA

If you are like most providers and industry consultants across the country, MACRA compliance is only recently becoming a slight irritation that lives somewhere at the bottom of your 2017 To Do List.  The yearlong flexibility period that runs through January 1, 2018, along with the varied choices and multi-tiered exceptions from MIPS granted by CMS make it just complicated enough to push off until later.

It’s actually a mistake to wait. That flexibility period is a temporary island. The water is lapping up around you and it’s not receding any time soon. Not only will requirements, payment adjustments and penalties become more rigid year over year, but your performance in 2017 will impact your 2019 reimbursement. Not understanding your MACRA options before the deadline will likely affect your bottom line.

So what is MACRA? It is the Medicare Access and CHIP Re-Authorization Act signed in April 2015 by President Barack Obama. It repeals the Sustainable Growth Rate (SGR) and mandates critical updates to the Medicare clinician payment process. MACRA locks in provider payment rates at near zero growth while stipulating the development of two payment tracks under the Quality Payment Program or QPP.

They are: 1) Advanced Alternative Payment Models (APM), and 2) Merit-Based Incentive Payment System (MIPS).

Clinicians and groups in the APM track must have at least 20% (but less than 25%) of their Medicare payments tied to an eligible APM in 2019 to start. Those percentage rates increase year over year.

Under MIPS, Medicare will consolidate and expand for all three of the pay-for-performance programs: Meaningful Use, the Value-Based Payment Modifier and the Physician Quality Reporting System. Under the new program, these programs are known as Advancing Care Information (ACI), Cost, and Quality, respectively. There also is a new program called Improvement Activities.

In the 2019, those categories will carry weights as such: Quality: 60%, Improvement Activities: 15%, and Advancing Care Information: 25%. Cost will carry 0% weight to start but that will increase over time.

Just focusing on one of the categories, Improvement Activities, there are several avenues to go down to help you qualify. For example, working with new Medicaid patients, having same day appointments available to your patients, working with emergency care programs… the list goes on.

Dizzy yet? The rules and regulations splinter out for each and every category. And importantly, which program [a2] you choose will impact whether you could be fined for non-compliance, if you are eligible for incentives or both.

The best attack is an informed one. Knowledge is a powerful tool as you set out to become compliant. 4medapproved has broken it down for you with several accredited courses covering the most important aspects of MACRA-MIPS.

In the one that begins this week, learn how to maximize incentive payments, avoid reimbursement penalties, and streamline reporting with these live workshops that cut through the red- tape and offer simple step-by-step instructions for success with MACRA compliance. This course is fully up to date with the MACRA Final Rule and is designed for 2017 reporting.

Successful completion of this course awards a Certification in MACRA-MIPS ACI and an optional Certification in MACRA-MIPS which have been reviewed and authorized by the 4Medapproved professional medical and technical advisory boards.

For a limited time, and only through this special link, save $150 off the cost of the course!

Topics covered include:

* Introduction to ACI for MIPS ECs
* ACI Reporting Options for 2017
* Required Objectives for the ACI Category
* Optional ACI Objectives for ECs Using a 2015 CEHRT
* Optional ACI Objectives for ECs Using a 2014 CEHRT
* Focus on Protecting Patient Health Info
* Patient Electronic Access
* Coordination of Care Through Patient Engagement
* Health Information Exchange
* ACI Scoring
* Introduction to Quality for MIPS ECs
* Where Quality Measures Come From
* Quality Measures
* Specialty Measure Sets
* Outcome Measures
* Reporting Methods
* Scoring the Quality Category
* Cost
* Improvement Activities

Successful completion of this course awards a Certification in MACRA-MIPS ACI and an optional Certification in MACRA-MIPS which have been reviewed and authorized by the 4Medapproved professional medical and technical advisory boards.

Course Instructor:

Wayne Singer is a Director of Certification & Development, EMR Advocate, Inc. and Partner at ZenonHealth, LLC He has an extensive background in healthcare coupled with experience in development.

Wayne has assisted vendors with their certification process. Additionally, he has worked with both hospitals and ambulatory providers with their Attestations, Audits and Appeals. His deep knowledge of CMS/ONC EHR certification, Interoperability and Value-based performance, provides him with the ability to successfully address the complex requirements surrounding these ever changing programs. Wayne’s leadership in development projects and expertise in Clinical Quality Measures and related interoperability issues have won him praise in the industry.

Megan Morris