RESOURCES

MACRA & MIPS

MACRA/MIPS Guarantee Overview

MTBC’s 2017 MACRA/MIPS Guarantee ("MACRA Guarantee") is available to MTBC's clients ("Client") who sign an MTBC Services Agreement - PracticePro™ on or after July 1, 2017 and go-live no later than December 1, 2017. If a Client enrolls in MTBC's MACRA Guarantee program and satisfies all of the terms and conditions of the MACRA Guarantee as set forth in the MACRA Guarantee Program Registration Form ("Registration") and nevertheless experiences a MACRA payment penalty based on Client's performance during the 2017 reporting year, MTBC will provide monthly service credits to such Client through the end of the year during which it experiences the payment penalty (i.e., 2019). Provided, however:

  • The amount of credit allowed during any given month will not exceed Client's total monthly fee to MTBC.
  • If Client's PracticePro™ Service Agreement with MTBC expires or terminates prior to Client receiving the full credit amount, Client will forfeit the remainder of the credit amount; and the credits will be Client's sole and exclusive remedy with respect to any downward payment adjustment to Client's Medicare reimbursements fee schedule during the applicable payment year.

Medicare Access & CHIP Reauthorization Act of 2015 (MACRA)

The Medicare Meaningful Use program as we know it ends in 2016, however it is being rebranded into the new performance based incentive program from CMS called Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). The act was passed by the bipartisan Congress and signed into law by President Obama in April 2015.

MACRA introduces the Quality Payment Program which emphasizes value-based models like MIPS and APMs.

macra

On October 14, 2016, the Department of Health and Human Services (HHS) issued the Final Rule on MACRA.

  • CMS made some significant changes in the proposed rule and offers more flexibility and pick-your-own-pace approach.
  • Reduced the number of required measures.
  • Reduced the time and cost for small practices*. Excluding more small practices from the program.
  • Simplified reporting and scoring.
  • Introduced the new Quality Payment Program website which explains the new program and helps clinicians identify the measures and activities that are most meaningful to their practice or specialty:qpp.cms.gov

Merit-Based Incentive Payment System (MIPS)

The Merit-Based incentive Payment System (MIPS) streamlines Medicare Meaningful Use, PQRS and Value-based Payment Modifier into one program.

MIPS will annually measure Medicare Part B providers in four performance categories to derive a score ranging zero to one-hundred, which can significantly change a provider's Medicare reimbursement in each payment year.

The performance categories under MIPS are:

  • Advancing Care Information (formerly Meaningful Use)
  • Quality (PQRS/VBM)
  • Clinical Practice Improvement Activities (New category)
  • Resource Use

Quality

Improvement Activities

Advancing Care Information

Cost

Replaces PQRS

New Category

Replaces the Medicare EHR
Incentive Program also
known as Meaningful Use

Replaces the Value-Based
Modifier

In 2017, your performance depends on three categories:

  • Quality which accounts for 60%
  • Advancing Care Information which accounts for 25%
  • Improvement Activities which accounts for 15%

Reporting Period and Deadline:

A minimum of 90-day continuous period is required. You can start any time between Jan 1st and Oct 2nd 2017. The deadline for data submission is: March 31st, 2018.

MIPS

For more information on MACRA and MIPS, please schedule a call with one of our industry specialists at (866) 266-6822 Ext 308 or reach us via email at mucoaches@mtbc.com