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MACRA and MIPS

Medicare Access & CHIP Reauthorization Act of 2015 (MACRA)

The Medicare Meaningful Use program as we know it ends in 2016, however it is being rebranded into the new performance based incentive program from CMS called Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). The act was passed by the bipartisan Congress and signed into law by President Obama in April 2015.

On October 14, 2016, the Department of Health and Human Services (HHS) issued the Final Rule on MACRA.

  • CMS made some significant changes in the proposed rule and offers more flexibility and pick-your-own-pace approach.
  • Reduced the number of required measures.
  • Reduced the time and cost for small practices*. Excluding more small practices from the program.
  • Simplified reporting and scoring.
  • Introduced the new Quality Payment Program website which explains the new program and helps clinicians identify the measures and activities that are most meaningful to their practice or specialty
WWS
WWS

Merit-Based Incentive Payment System (MIPS)

The Merit-Based incentive Payment System (MIPS) streamlines Medicare Meaningful Use, PQRS and Value-based Payment Modifier into one program.

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.

The performance categories under MIPS are:

  • Advancing Care Information (formerly Meaningful Use)
  • Quality (PQRS/VBM)
  • Clinical Practice Improvement Activities (New category)
  • Resource Use