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Are you a small practice clinician worried about the Medicare Access and CHIP Reauthorization Act (MACRA)? If so, you’re not alone. Most clinicians are still unsure of its impact, leading to concern and frustration for many. While the end-goal of the Quality Payment Program (QPP) sounds simple-- reward clinicians based on the value of the care provided-- the requirements and details of the program are quite complex.
What Is MACRA?
In short, MACRA establishes a new payment system for clinicians who treat Medicare patients. The new program is part of an industry shift to value-based reimbursement and consolidates previously government-mandated programs like, Meaningful Use (MU), Physician Quality Reporting System (PQRS) and the Value-Based Payment Modifier. Not familiar with MACRA? Read MACRA Simplified: 3 Steps to Understanding the Quality Payment Program, to get caught up on the basics.
What Do I Need To Do?
Although there’s still confusion around the program, the reality is clinicians need to participate to avoid a negative payment adjustment. Suit yourself with knowledge, seek guidance, get more information as needed and submit data to ensure your small practice receives the Medicare reimbursements you earned.
Where Can I Go For More Information?
To provide more clarity around the program and to help clinicians participate this first year, the Centers for Medicare and Medicaid Services (CMS) announced new resources that have recently become available. If you feel like you’re lost in MACRA space or need more QPP guidance, take a look below at the compiled list of helpful resources from CMS.
- The QPP Website - The QPP website has been up for some time now, but CMS has recently revamped the whole site. The new site has more clear and detailed information for each track as well as helpful tools, like a participation status checker where clinicians can enter their National Provider Identifier (NPI) number to find out if they’re eligible for the MIPS track.
- MIPS Quick Start Guide: This guide outlines the steps clinicians participating in MIPS should take between now and March 2018 to prepare for and participate in MIPS, such as checking participation status, choosing to participate as an individual or as part of a group, deciding how to submit data, and selecting measures and activities.
- Medicare Shared Savings Program and Quality Payment Program Fact Sheet: This fact sheet provides detailed information on how the Shared Savings Program and the Quality Payment Program align reporting requirements for participating Accountable Care Organizations (ACOs) and MIPS clinicians, and how certain tracks in Shared Savings Program ACOs meet Advanced Alternative Payment Model (APM) criteria under the QPP.
- MIPS APM Fact Sheet: This fact sheet provides an overview of the MIPS APM, a specific type of APM, as well as information about the special APM scoring standard used for clinicians participating as MIPS APMs.
For more information about the QPP clinicians can also contact the QPP Service Center by phone (1-866-288-8292) or email (QPP@cms.hhs.gov).
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