The Medicare Access and CHIP Authorization Act,

(MACRA),has been met with widespread relief and

a tad bit of suspicion. As always conspiracy theorie

and unanswered questions are in the air

Here are 10 major questions that everybody wants an answer for

Here are 10 major questions that everybody wants an answer fo

What exactly is MACRA?

How will MACRA impact payments?

Tell me more about MIPS

Taking Action

Am I eligible to participate in MIPS?

Will MACRA eliminate fee for service?

What should I do prepare myself for

MIPS?
What are the data submission
requirements
of MIPS? Taking Action

What should I do prepare myself for

MIPS?

Will MACRA eliminate fee for service?

10

What should I do prepare myself for

MIPS?

Taking Action

What exactly is MACRA?

#1
The Medicare Access and CHIP Authorization Act, (MACRA),
will permanently replace the dreaded Sustainable Growth Rate
formula for determining payments.
MACRA seeks to:
Provide payments based on quality and outcomes rather than volume.
Health information technology will play a major role .
To consolidate major incentive programs like PQRS, value based payment

modifier, Meaningful Use and the Medicare Electronic Health Record incentiv
program into one single, comprehensive framework.

How
#2 will MACRA impact payments?
There are 2 paths for payment in the MACRA legislation.
The Merit Based Payment System (MIPS)
Alternative Payment Models (APMS)

Tell me more about MIPS

#3
Eligible clinicians will be evaluated based on 4 categories:
Quality- based on the existing PQRS system
Resource use: based on the Value based payment modifier model
Advancing Care Information: which is similar to MU mandates
Clinical practice improvement categories

Am
#4I eligible to participate in MIPS?
You are eligible if you are a physician, registered nurse
practitioner, clinical nurse specialist, certified registered
nurse anaesthetist.

Going forward, the secretary may broaden the eligible clinician group
to make occupational therapists, speech language pathologists and
nutritional professionals to become eligible to participate in MIPS as well.

Will
#5MACRA eliminate fee for service?

ACRA preserves the fee for service model. Physicians who

low the fee for service model can participate in the

PS program.

What are the data submission

#6
requirements of MIPS?
MACRA intends to follow a single, unified data submission
method for all the performance categories.

To achieve this goal MIPS expands on the existing quality measures and
simplifies the data submission process.

What should I do to prepare myself

#7
for MIPS?
If you are already reporting quality measures under the
existing incentive programs identify and focus on your high
performing quality measures.

Evaluate and educate your staff on QRUR (quality resource and use report) by

CMS and see how improvements can be made .

Analyse your PQRS feedback reports and monitor your current quality metrics

across Medicare and private payers.

What is the Advanced Alternative

#8
Payment Model?
AAPMs are performance based payment methods that CMS
will follow to reimburse physicians who care for Medicare
beneficiary. CMS will release a list annually on the care models
that qualify for AAPM incentives.

Providers who participate in qualifying AAPMs will be eligible for APM payments

and bonuses and are exempt from participating in MIPS.

However, all providers will report under MIPS in 2017. CMS will take a decision on

linicians who will qualify for APM status.

What are the eligibility criteria

#9
for participating in AAPMs?

oviders will have to use certified EHR technology, base

ayments on quality measures akin to MIPS and shoulder

onetary risk for financial losses incurred.

How
do I prepare myself to participate in AAPMs?
#10
Choose quality measures that have a higher chance of success

dentify opportunities to improve patient care and achieve savings for payers

mplement clinical and financial strategies to help meet your chosen quality meas

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macra-faqs/