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MACRA - what you need to do in 2017

Step One

MACRA is a complex law, and it will require work from all of us. With MACRA, we have the stability of knowing what to expect, and the potential of increased payments and even bonus payments (along with the possibility of negative updates). CMS has named 2017 a transition year to "Pick Your Pace," which gives you time to learn and adjust to the Quality Payment Program (QPP). If you participate in "pick-your-pace" at any level of participation in 2017, you will avoid potential penalties in 2019, the first year of MACRA implementation. The MACRA updates in 2019 start as high as 4 percent (plus or minus) and go up slowly each year, but they come nowhere close to the cuts we faced under the SGR.

Are you already meeting some MACRA requirements? The answer is likely yes!

  • you have already been reporting quality measures under the Physician Quality Reporting System and/or have participated in meaningful use,
  • you have been involved in clinical improvement reporting -- such as through the Family Medicine Certification process (formerly known as Maintenance of Certification), or perhaps through insurance plan requirements

Here's what you need to do by Sept. 30th (3rd quarter) in order to avoid a 2019 negative payment adjustment:

Learn all about the Quality Payment Program which ends the SGR formula and gives you new tools, models, and resources to help you give your patients the best possible care. You can choose how you want to take part based on your practice size, specialty, location, or patient population. The Quality Payment Program has 2 tracks you can choose from:

  1. The Merit-based Incentive Payment System (MIPS)
  2. Advanced Alternative Payment Models (APMs)

Understand how MIPS and APMs will go into effect over a timeline from 2015 through 2021 and beyond. 

  • Use the following tools to identify specific measures you can report to meet the requirements:
    • Use this tool to browse the different MIPS quality measures https://qpp.cms.gov/measures/quality
    • Use this tool to browse the advances in care objectives and measures (formerly meaningful use) https://qpp.cms.gov/measures/aci
    • Use this tool to browse the different MIPS improvement activities https://qpp.cms.gov/measures/ia For groups with fewer than 15 participants or if you are in a rural or health professional shortage area: Attest that you completed up to 2 activities (versus up to 4) for a minimum of 90 days.

 For additional references, the AAFP and AMA links are provided below:

 http://www.aafp.org/practice-management/payment/macraready.html

 https://www.ama-assn.org/practice-management/medicare-payment-delivery-changes

The IAFP Board of Directors is open to suggestions on how we may better serve you in your practice and improve your well-being. Look to similar IAFP emails and education opportunities in the future as we attempt to convey overwhelming data into "bite-size sources". 

Email me at [email protected]. 

Donald R. Lurye, MD, MMM, CPE