MACRA

MACRA – Understanding the New Rules

As a Certified Meaningful Use Stage 2 EHR by ONC, MD Logic meets the MACRA related requirements. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) presents a new value-based reimbursement system called (QPP) Quality Payment Program. With this program comes the following important changes that will impact Medicare payments.

SGR
Repeals the Medicare sustainable growth rate (SGR) formula that calculated payment cuts for physicians.

MIPS/APMs
Creates a new framework for rewarding physicians for providing higher quality patient care. The (2) tracks of the QPP are:

  • Merit-based Incentive Payment System (MIPS)
  • Alternative Payment Models (APMs)

SGR
Repeals the Medicare sustainable growth rate (SGR) formula that calculated payment cuts for physicians.

MIPS/APMs
Creates a new framework for rewarding physicians for providing higher quality care. The two tracks of the QPP are:

  • Merit-based Incentive Payment System (MIPS)
  • Alternative Payment Models (APMs)

Consolidates
Parts of three existing individual reporting programs are combined into a single system:

  • Physician Quality Reporting System (PQRS)
  • Value-Based Payment Modifier (VBPM)
  • Meaningful Use (MU)

Understanding MIPS?

MIPS (Merit-based Incentive Payment System) is a scoring program measuring an eligible clinicians performance to weigh their Medicare Part B payment adjustments, these adjustments may be positive, negative or neutral. The MIPS payment adjustments are applied two years after the performance year with January 1, 2017 proposed as the first year for the MIPS program. The payment adjustments will be applied in CY2019.

MIPS - 1st Year Performance Category

  • Quality: (6) Measures
  • Advancing Care Information: (6) Objectives
  • Clinical Practice Improvement Activities: (90) Activities (Examples: Patient Safety, Care Coordination, Population Health)
  • Cost of Resource Use: No additional reporting necessary as this is based on Medicare Claims

Understanding AMP?

CMS proposes an approach to implementing the MACRA APM track where eligible clinicians can become “qualifying participants” & earn incentives for participation. Advanced APMs must meet three proposed requirements deriving from the MACRA statute:

  • Required use of a Certified EHR (MD Logic Meets this requirement)
  • Payment for covered professional services based on comparable quality measures
  • Either being an enhanced medical home or bearing more than “nominal risk” for losses

Peace of Mind for MD Logic Customers

MD Logic meets EHR regulations and at the same time offers the fastest solution in the market for documenting patient care. We are committed to providing our customers with the technology they need to meet EHR regulations for MACRA.