Preparing Your Organization for MACRA 1.0

This article provides an overview of MACRA and guidance about what health systems should do to prepare for MACRA now. MACRA Overview MACRA permanently replaces the unsustainable Sustainable Growth Rate (SGR) formula (created in 1997 to restrict growth in Medicare Part B spending) with a system that attempts to prioritize quality over quantity. It also replaces Medicare’s multiple quality reporting programs with a single Merit-Based Incentive Payment System (MIPS). Before MACRA, several programs such as Accountable Care Organizations (ACOs), bundled payments, and various value-based models existed for hospitals and eligible professionals. Under MACRA, providers will receive a .5 percent annual increase until 2019, at which point they can choose between two value-based payment tracks: MIPS or Alterative Payment Models (APMs). Meaningful use will be moved under MACRA in both tracks. Two Value-Based Payment Tracks: MIPS and APMs Starting in 2019, providers can choose between MIPS and APMs: MIPS MIPS will be the default system, and consolidates the existing Meaningful Use, Physician Quality Reporting System (PQRS), and Value-Based Payment Modifier (VBM) programs. Physicians that choose this track face payment reductions and increases based on performance. An overall MIPS score will be calculated according to performance in four measures (weighted by performance, with potential changes in weight by year): Quality (30 percent) Resource use (30 percent) Meaningful use (25 per...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Featured THCB ACOs Bobbi Brown CMS HealthCatalyst Kate Goodrich MACRA MIPS SGR Source Type: blogs