Mutual Matters

Time to start reporting measures for the MACRA Quality Payment Program

Posted by Bill Kanich, MD on Jul 12, 2017 1:00:00 PM

MMIC_Doctor_Time.jpgThe clock is ticking on the initial reporting period for MACRA; the actions you take now will determine your Medicare reimbursement rates in 2019. If you plan to participate in MIPS, failure to take any action will result in a 4% negative adjustment to your Medicare reimbursement in 2019.  An overview of MACRA and its potential impact on your practice can be found here.

The good news is the Centers for Medicare & Medicaid Services (CMS) has designated 2017 as a transition year in which you can “Pick Your Pace” when it comes to reporting Quality Measures, Advancing Care Information and Improvement Activities. This will allow eligible clinicians (ECs) more time to learn about reporting under MIPS and adjust to the Quality Payment Program (QPP).

Under “Pick Your Pace” practitioners will have four options for measuring and submitting data:

            Option 1:          Action: Do nothing in 2017

                                    Result: Medicare reimbursement will be negatively adjusted 4% in 2019

            Option 2:         Action: Submit a minimum amount of data

                                    Likely Result: Avoid a negative 4% Medicare payment adjustment

What is a “minimum amount of data”? Submit data for one quality measure OR one improvement activity OR 4 or 5 (depending on CEHRT edition) required Advancing Care Information measures.

            Option 3:         Action: Partial Participation

Likely Result: Avoid a negative adjustment, MAY qualify for positive adjustment

Submit at least 90 days of data for 6 Quality Measures (including 1 outcome OR 1 high-priority measure) AND attest to Improvement Activities AND submit more than the base score for the Advancing Care Information requirement.

            Option 4:         Action: Full Participation

Likely Result: Avoid a negative adjustment, MAY qualify for positive adjustment

Submit a full year of data for 6 Quality Measures (including 1 outcome OR 1 high-priority measure) AND attest to Improvement Activities AND submit more than the base score for the Advancing Care Information requirement. NB: The “full year” started on January 1, 2017.

Whatever option you choose, the time to act is now. Failure to take any action will result in a negative adjustment to your Medicare reimbursement. 

Find more resources by visiting the MagMutual Learning Center. 

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As one of the leading mutual providers of Medical Professional Liability insurance, we're here to help all healthcare professionals with the challenges they face on a daily basis. The topics we cover include: 

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