In April 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
On October 14, 2016, the Department of Health and Human Services issued its final rule with comment period implementing the Quality Payment Program that is part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA ended the Sustainable Growth Rate formula. The Quality Payment Program policy will reform Medicare payments for more than 600,000 clinicians across the country. The Quality Payment Program has two tracks.The Merit-based Incentive Payment System (MIPS)Clinicians are eligible to participate in the MIPS track of the Quality Payment Program if you bill more than $30,000 to Medicare, and provide care to more than 100 Medicare patients per year, and you are a physician, physician assistant, nurse practitioner, clinical nurse specialist or certified registered nurse anesthetist. Advanced Alternative Payment Models (APMS) Advanced APMs are a subset of APMs and let practices earn more for taking on some risk related to patients’ outcomes. Clinicians may earn a 5 percent Medicare incentive payment during 2019 through 2024 and be exempt from MIPS reporting requirements and payment adjustments if you have sufficient participation in an Advanced APM. Advanced APMs must meet certain requirements to be eligible.The links below provide additional tools and resources about MACRA.
Centers for Medicare and Medicaid Services
American Hospital Association
Great Plains Quality Innovation Network (KFMC)
CMS Training Videos
For more information, contact Karen Braman, (785) 233-7436.