Coming Soon: Major Changes to Medicare Payment

 In Articles, MACRA, MIPS, News

What is MACRA? And what does my practice need to do?

The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) is part of CMS’s latest push toward value and quality. This legislation is responsible for many of the new changes, including the repeal of the Sustainable Growth Rate (SGR) Formula, revisions to how Medicare rewards clinicians for value over volume, and creation of bonus payments for participation in eligible alternative payment models (APMs).

Under MACRA, the most immediate and monumental change that will affect your practice is the new Merit-Based Incentive Payments System (MIPS), which streamlines multiple quality programs.

Steps to get ready

PQRS, Value-Based Modifiers and Meaningful Use programs will all sunset with the 2018 payment year, which is based on 2016 data. MIPS takes its place starting with the 2017 reporting year. Final rules are expected in November, leaving very little time for practices to adapt processes and systems. Here are steps your practice can take to get ready:

  • Learn all you can about the proposed details of the MIPS program for 2017. View this MSOC Health handout for an overview. See below for additional learning opportunities from MSOC. Other helpful resources include CMS itself and your Specialty Association.
  • The comment period ends June 27 and this is your opportunity to express your views on this new program. Share your comments regarding the proposal with CMS directly, your Specialty Association, or the Government Affairs Office of MGMA. There will be changes to the proposed rules. Make sure your voice is heard.
  • Participate fully in PQRS and MU for 2016 to avoid penalties in 2018; estimate your 2016 results using the proposed MIPS rules to understand where to focus efforts for the 2017 reporting year.
  • Review your QRUR reports for historical performance on costs and quality.
  • Create a preliminary plan for 2017, then adjust based on the final rules; you’ll want to have a solid plan in place by January 2017.

MSOC is here to help

MSOC staff will be providing educational webinars on MACRA and MIPS. We’ll be sending invitations to our billing clients for complementary webinars in June and July. You can also register for one of the following scheduled sessions:

MSOC Health has developed a comprehensive MIPS Consulting Package to help practices get ahead. Read the details here. For questions and to sign-up, contact Jeanne Chamberlin at or 919.442.2422.

The MIPS Consulting Package is designed to help your practice navigate the complexities of MACRA. LEARN MORE.

Recommended Posts

Start typing and press Enter to search

AetnaModern Healthcare