Breaking Down The MACRA Proposed Rule

The mother ship has landed. On Wednesday, April 27, the Centers for Medicare and Medicaid Services (CMS) released the highly anticipated proposed rule that would establish key parameters for the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). These policies were established by the latest, permanent ‘doc fix,’ the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). For additional background, please refer to recent Health Affairs Blog posts on MACRA, MIPS, and APMs, as well as a comprehensive brief on MACRA. This post briefly outlines the key elements of the proposed rule. MIPS The proposal defines which eligible clinicians will initially participate in the Quality Payment Program via MIPS, with CY 2017 proposed as the first performance period on which CMS plans to base the CY 2019 payment adjustment. Eligible clinicians include physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and groups that include such clinicians. As outlined in MACRA, the proposal would consolidate three currently disparate Medicare quality programs into MIPS: (1) the Physician Quality Reporting System; (2) the Value-Based Modifier Program; and, (3) the ‘Meaningful Use’ of electronic health records. CMS proposes that eligible clinicians receive a composite score relative to their performance in each of four categories. Qua...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Featured Health Professionals Medicaid and CHIP Medicare Organization and Delivery Payment Policy Quality APMS CMS EHRs MACRA mips payment models Source Type: blogs