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Time to start reporting measures for the MACRA Quality Payment Program

July 12, 2017

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  • Evaluate
  • Mitigate
  • Manage
  • Restore
  • Improve

The clock is ticking on the initial reporting period for MACRA; the actions you take now will determine your Medicare reimbursement rates in 2019. If you plan to participate in MIPS, failure to take any action will result in a 4% negative adjustment to your Medicare reimbursement in 2019.  An overview of MACRA and its potential impact on your practice can be found here.

The good news is the Centers for Medicare & Medicaid Services (CMS) has designated 2017 as a transition year in which you can “Pick Your Pace” when it comes to reporting Quality Measures, Advancing Care Information and Improvement Activities. This will allow eligible clinicians (ECs) more time to learn about reporting under MIPS and adjust to the Quality Payment Program (QPP).

Under “Pick Your Pace” practitioners will have four options for measuring and submitting data:

Option 1: Action: Do nothing in 2017

Result: Medicare reimbursement will be negatively adjusted 4% in 2019

Option 2: Action: Submit a minimum amount of data

Likely Result: Avoid a negative 4% Medicare payment adjustment

What is a “minimum amount of data”? Submit data for one quality measure OR one improvement activity OR 4 or 5 (depending on CEHRT edition) required Advancing Care Information measures.

Option 3: Action: Partial Participation

Likely Result: Avoid a negative adjustment, MAY qualify for positive adjustment

Submit at least 90 days of data for 6 Quality Measures (including 1 outcome OR 1 high-priority measure) AND attest to Improvement Activities AND submit more than the base score for the Advancing Care Information requirement.

Option 4: Action: Full Participation

Likely Result: Avoid a negative adjustment, MAY qualify for positive adjustment

Submit a full year of data for 6 Quality Measures (including 1 outcome OR 1 high-priority measure) AND attest to Improvement Activities AND submit more than the base score for the Advancing Care Information requirement. NB: The “full year” started on January 1, 2017.

Whatever option you choose, the time to act is now. Failure to take any action will result in a negative adjustment to your Medicare reimbursement. 

Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.

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