The Medicare Meaningful Use program as we know it ends in 2016, however it is being re branded into the new performance based incentive program from CMS called Medicare Access & CHIP Reauthorizing Act of 2015 (MACRA). The act was passed by the bipartisan Congress and signed into law by President Obama in April 2015.
Approximately 50 percent of doctors reported they have not yet heard of the payment reform Medicare Access and CHIP Reauthorizing Act of 2015 (MACRA).
Are you not aware about on MACRA / MIPS? Find out why it matters:
What is MACRA?
MACRA combines parts of the Physician Quality Reporting System (PQRS), Value-based Payment Modifier (VBM), and the Medicare Electronic Health Record (EHR) incentive program into one single program called the Merit-based Incentive Payment System, or “MIPS”.
According to the Centers for Medicare and Medicaid Service (CMS), MACRA is an important stepping stone in the switch to value-based care. It also gives clinicians two options for linking payments to value:
- Merit-Based Incentive Payment System (MIPS): According to CMS, MIPS measures physicians on quality, resource use, clinical practice improvement and meaningful use of electronic health records.
- Alternative Payment Models (APMs):Examples of APMs include Accountable Care Organizations (ACOs) and Patient Centered Medical Homes (PCMHs). By using these models, providers receive lump-sum payment incentives.
What is MIPS?
Merit-based Incentive Payment System, also known as MIPS, streamlines three previous pay-for-performance programs and adds a fourth component to promote the ongoing improvement and innovation to clinical activities.
MIPS will annually measure Medicare Part B providers in four performance categories to derive a score ranging zero to one-hundred, which can significantly change a provider’s Medicare reimbursement in each payment year.
There are four MIPS performances categories are as follows:
- Quality (replaces PQRS and parts of VBM).
- Advancing Caring information (replaces EHR meaningful use).
- Clinical Practice Improvement Activities (New category).
- Resource Use.
“Medicare Access and CHIP Reauthorizing Act of 2015. The act was signed into law in early 2015 and makes substantial changes to the government’s health care payment system. The Sustainable Growth Rate formula for determining provider payments and changing the Medicare physician fee schedule by establishing two new options for reimbursement: The Merit Based Incentive Payment System (MIPS) and Alternate Payment Models (APMs).”