Moops?: A Roadmap To MIPS

After a seemingly endless stream of stop-gap “doc fixes,” President Obama on April 14, 2015, signed into law a permanent repeal and replacement of Medicare’s Sustainable Growth Rate formula. The 2015 law, known as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (P.L. 114-10), permanently reformed Medicare physician payments and (finally) put to rest what had become a dreaded perennial legislative ritual of blocking reimbursement cuts. See my Health Affairs Blog post from last April for more on that. MACRA’s Two Physician Payment Pathways: MIPS And APMs MACRA replaced the Sustainable Growth Rate with annual 0.5 percent payment increases for each of the next five years, and creates two tracks for physician payment after that. Under one track, MACRA streamlines certain Medicare quality initiatives that affect reimbursement under a unified system known as the Merit-Based Incentive Payment System (MIPS). MIPS is the subject of this post. Under the other track, physicians can get bonus payments/incentives if they receive a “significant share” of their revenue through an alternative payment model (APM). Physicians who receive payment through their participation in an APM above a certain threshold will not be subject to payment adjustments under MIPS. MIPS 101 MIPS reflects a doubling down on existing performance measurement and improvement initiatives. Beginning in calendar year 2019, Medicare payments will be adjusted based on provider performance in MI...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Insurance and Coverage Medicaid and CHIP Medicare Payment Policy Congress MACRA Merit-Based Incentive Payment System Physicians Source Type: blogs