Day 7: Answers to a Bevy of MACRA Questions

number7-red-200On the 7th Day of Christmas my true love sent to me, seven swans a swimming…

2016 was a YUGE year. Not only did we witness the mother of all elections, we saw the Final Rule for the Medicare Access & CHIP Reauthorization Act (MACRA) pass with bi-partisan support, in October. The law repeals the Medicare Sustainable Growth Rate (SGR) and provides physicians with two paths to reimbursement.

Unlike repeal talks threatening Obamacare, MACRA is here to stay. And it starts in January.

Have questions about MACRA? QPP? MIPS? APMs? Or how MU fits into all of this? It is a bevy of questions we look to address to make sure you’re not swimming up stream to meet the new CMS Medicare reimbursement models. Here are 7 resources to help you navigate the MACRA waters in 2017. MACRA resources – CMS has done a great job of providing FAQs and resource pages to help proviiders understand what they need to do. The Agency starts with defining the Quality Payment Program (QPP), which ends the Sustainable Growth Rate formula and gives providers two reimbursement tracks to choose from: The Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).

CMS Quality Payment Program Website – In November CMS launched a new online tool to electronically capture data from providers for QPP. Providers can begin collecting performance data starting Jan. 1, 2017. For providers not quite ready, CMS offers a “pick your pace” process –  you can choose to start anytime between January 1 and October 2, 2017. But no matter when you choose to start, you’ll need to send in your performance data by March 31, 2018. You can also begin participating in an Advanced APM in 2017, which may qualify for a 5% incentive payment in 2019.The first payment adjustments based on performance go into effect on January 1, 2019.

The AMA Payment Model Evaluator – AMA has a number of resources to educate members and non-members on MACRA. Through the AMA’s website you can take an assessment to help you figure out where your practice stands under MACRA.

SA Ignite – We’ve been co-hosting a monthly webinar series on MACRA and MIPS with SA Ignite since June of 2015. SA Ignite also provides FAQs, blog posts, and a MIPS calculator. You can also check out our series on YouTube, and on our HealthcareNOWradio website as podcasts.

MU/MIPS Expert Jim Tate – Our own expert on all things meaningful use has been looking at MIPS since the proposed rule through a series of blog posts. With MU transitioning to Advancing Care Information (ACI) under MIPS, many providers have questions on how this transition will work going into Stage 2 MU. Read his blog articles here. 

Justin Barnes – Another expert in our fold and host of our Internet radio show This Just In, Justin Barnes is a well known national thought leader and speaker on the industry’s transition to value based care. Check out his recorded series of webinars on MACRA/MIPS on – Other experts from the industry have contributed articles on MACRA.  Check out these SME’s from ZirMed, Group One, eHealthcare Consulting, and others under our MACRA feed, our MIPS feed, and our QPP feed.