MACRA’s Paths: MIPS and APMs

The scoring method is complex, but simply put: MIPS providers will be scored in four separate performance categories (Which are each weighted differently), and the sum of these scores will amount to a total, aggregated “composite” score.

MIPS

The following programs as we know them have ended, have been repackaged, and rolled into MACRA/MIPS:
• Meaningful Use
• Value-Based Modifier
• Physician Quality Reporting System

MIPS Performance Categories

The four performance categories that will make up MIPS participants’ total score are as follows:
Quality: 60%
Advancing Care Information: 25%
Clinical Practice Improvement: 15%
Resource Use/Cost: 0% (No reporting is required for this. It’s calculated from adjudicated claims.)

Remember: Unlike old programs (such as PQRS), which worked similarly to a “pass/fail” grading system, MIPS providers are “graded” on a curve.

Flexibility: For the first reporting period 2017

CMS has declared 2017 as a transition year for MACRA. Providers who qualify for MIPS can “pick their pace.” MediTouch software will allow each provider to choose their reporting period for the year.

Full year: Prepared? Report a full calendar year of data; possible full bonus.
Partial year: Somewhat prepared? Report all requirements for less than a year; possible smaller bonus
Report anything: Not prepared? Report any data for less than a year; no penalty, no bonus.

* Report nothing in the first year of MACRA will receive a -4% penalty.

How Will the Payment Adjustments Work?

In the first year of MACRA, 2017: A provider who chooses to report for the full calendar year has the *potential to earn up to 4% positive payment adjustment, depending on how high above the bell curve he or she lands. Those providers who perform as “A” students on the curve “could” receive a “modest” payment adjustment. The very few who perform as Valedictorians have the potential to receive up to a 12% positive payment adjustment in the first year. Payment adjustments increase with each year until 2020 and beyond.

How Can MediTouch Help You?

  • Easily accessible dashboards for physician performance
  • Automated quick actions to improve score of entire population
  • Easy comparison of provider performance across practice
  • Detailed views and patient summaries for quick action to improve scores
  • Track performance on selected measures and report on top CQM
  • Automated reporting for easy submissions to CMS
  • Detailed training modules and customer support on all aspects of MACRA