Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
CMS Awards approximately $100 Million to Help Small Practices Succeed in the Quality Payment Program
On February 17, CMS awarded approximately $20 million to 11 organizations for the first year of a five-year program to provide on-the-ground training and education about the Quality Payment Program for clinicians in individual or small group practices of 15 clinicians or fewer. These local, experienced, community-based organizations will provide hands-on training to help thousands of small practices, especially those that practice in historically under-resourced areas, including rural areas, health professional shortage areas, and medically underserved areas. The training and education resources will be available immediately, nationwide, and will be provided at no cost to eligible clinicians and practices.
CMS also launched a new telephone helpline for clinicians seeking assistance with the Quality Payment Program at 866-288-8292 or firstname.lastname@example.org.
For more information, visit the Quality Payment Program website. See the full text of this excerpted Press Release (issued February 17), including organizations that were awarded contracts.
When you open the 2/17/17 press release, you will notice that IPRO is one of the 11 organizations. Questions can be sent to IPRO at email address:
NY-QPP@atlanticquality.org or you can call IPRO at 1-866-333-4702.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care.
APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of Medicare’s existing incentive programs.
- The Quality component replaces the Physician Quality Reporting System (PQRS).
- Cost replaces the Physician Value-based Payment Modifier (VM).
- Advancing Care Information replaces the Medicare Electronic Health Record (EHR) Incentive Program also known as Meaningful Use (MU) for Eligible Professionals (EPs).
- MIPS contains a new component/category called Improvement Activities.
Scoring of these four MIPS components will determine whether or not you will earn a performance-based payment adjustment to your Medicare payment in 2019. It is expected that under this Program, Medicare will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies.
In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.
For more information, please follow these links:
Quality Payment Program Long Version Executive Deck PowerPoint Slides
Correspondence from the AMA
AMA presentation that summarizes MACRA
MPIs Quality Measures
Some of our members might like some help in finding their specialty specific quality measures for MIPs reporting.
Please see this link: qpp.cms.ov/mips/quality-measures
If your specialty is not listed, please go to your national specialty society website and search on the terms PQRS, MIPS, and/or MACRA to see if they might have some measure(s) that might help.
Qualified Clinical Data Registries
This document contains a listing of Qualified Clinical Data Registries (QCDRs) including detailed information of the services each QCDR offers, the cost incurred by their clients, as well as the measures they are supporting. These entities have self-nominated and indicated that they meet the requirements as outlined by CMS in the Medicare Physician Fee Schedule (PFS) final rule. Eligible professionals wishing to participate using the Qualified Registry reporting option should review this document by clicking on the following link: Qualified Clinical Data Registries. https://qpp.cms.gov/mips/quality-measures
If you have questions, send an email to
email@example.com. Remember, MSSNY email is not HIPAA-secure, so please do NOT include any PHI!