With all of the challenges of attesting for Meaningful Use Stage 2 in 2014, rumblings about opting out of the program have been coming from a number of practices. That is a decision that every provider needs to make for him- or herself, but make sure you are making an informed decision about Meaningful Use and other CMS programs, knowing how this will impact your future practice income.

As we have mentioned on this blog in the past, these CMS programs, from Meaningful Use to PQRS, eRX and others, were never truly designed to be incentive programs. The fact is that these are penalty programs, front-loaded with incentives to encourage rapid change.

So before you decide which programs to participate in and which to ignore in 2015, be aware that your decisions will impact your bottom line in 2017.

On an MLN Connects National Provider Call in July, CMS representatives explained the impact of the various proposed 2017 penalties on providers based on 2015 performance. The details are outlined in the chart below.

CMS Penalties 2017

That’s right: CMS is proposing penalties that break down like this:

2% reduction for PQRS

+

4% reduction for the value-based modifier program

+

3% Meaningful Use penalty

= 9%

Total potential loss for key specialties

As you can see above, what all of these penalties add up to is a potential loss of 9% of your Medicare reimbursement in 2017, depending on your level of past participation in Meaningful Use. For some of the most highly reimbursed specialties, this can mean a loss of more than $20,000 per provider for the year—right off the top. Here’s a look at the impact for five key specialties:

CMS Penalties by Specialty

Also important to note is the fact that in 2015, you lose an option you have for 2014. For this year, providers could avoid a payment reduction for 2016 by using the claims method to report on at least three PQRS measures and for each measure, reporting on at least 50 percent of eligible patients. This option is not available for 2015. We don’t recommend this method anyway, since it doesn’t take advantage of the alignment between PQRS and Meaningful Use, essentially requiring you to duplicate effort.

Overall, the key take-away here is that it’s becoming more important to report successfully for PQRS, and for Meaningful Use as well, due to the cumulative effect of these penalties. It’s no longer a matter of 1% or 2%; it’s becoming a serious total penalty.

We’ll explain more about the value-based modifier program in an upcoming blog; watch here for a look at this new, rather complicated program that could cost you 4% of your Medicare reimbursements.

To insure that you are successful with your 2015 PQRS reporting, make sure your EHR software provides the features and reporting you need. MediTouch includes the reporting and guidance necessary to protect your practice from any penalties related to PQRS or Meaningful Use.


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