On October 14, 2016 CMS released the final rule for on of the most bipartisan and significant Legislative changes to Medicare in a generation, the Medicare Access and CHIPS Re-authorization Act of 2015 (MACRA). MACRA repeals the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with a new value-based reimbursement system called Quality Payment Program (QPP). The Quality Payment Program consists of two major tracks:
- The Merit-based Payment System (MIPS)
- Advanced Alternative Payment Models (Advanced APMs)
This paper includes information from the CMS rules and updated with 2018 information from the Bipartisan Budget Act of 2018 with 10 FAQs answered.
- What is MIPS?
- What are the financial and reputational impacts of MIPS?
- Who is subject to MIPS?
- What determines a clinician’s MIPS score?
- How is the Quality performance category scored?
- How is the Cost performance category scored?
- How are the Advancing Care Information (ACI) and Improvement Activities (IA) performance categories scored?
- What are MIPS data submission and audit requirements?
- How is MIPS different in 2018 versus 2017, and how will it further change in 2019?
- How does an organization sustainably succeed on the MIPS path?
Also read Modifications to MIPS by the “Bipartisan Budget Act of 2018” by Tom S. Lee, Founder & CEO of SA Ignite.
