Understanding the CMS Proposed Rule for the Medicare Access and CHIP Reauthorization (MACRA) and the Merit-Based Incentive Payment System (MIPS)

As we have reported, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule to implement the Medicare Access and CHIP Reauthorization Act (MACRA). This is a significant rule with fundamental changes for Medicare. In our continuing coverage, we will provide a more detailed analysis of the regulation. Today, we look at the rule's content related to the Merit-based Incentive Payment System (MIPS). As a refresher, the rule creates a two-track Quality Payment Program. The first is called the Merit-based Incentive Payment System (MIPS) consolidates components of the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program. A second track involves alternative payment models (APM). Because of the high bar set to qualify for the APM track, CMS projects that only 30,000 to 90,000 clinicians will be in the APM track. An estimated 687,000 to 746,000 physicians will be in MIPS. The program will begin grading physicians in 2017 for changes in their payments starting 2019. You can learn more at one of the many CMS webinars listed here. MACRA Background Last year, Congress and President Obama approved a bipartisan bill for United States healthcare reform, the bill known as the "doc fix" bill, or "MACRA," which stands for Medicare Access and CHIP Reauthorization Act of 2015. MACRA repealed the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula ...
Source: Policy and Medicine - Category: American Health Authors: Source Type: blogs