With the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) steaming full speed ahead toward medical practices, it’s time to be ready for payment changes.
When it comes to the Merit-based Incentive Payment System (MIPS), healthcare management consultant Mary Jean Sage of The Sage Associates in Pismo Beach, California, urges physicians to be proactive instead of reactive to reap the program’s benefits.
1. Know that MIPS is your friend.
Yes, this is all new, but physicians have done new before, she says. Also remember that some existing Medicare programs are simply renamed but that MACRA is here to stay. Decide now if the practice wants to survive or thrive, and be aware of the financial implications of that decision, Sage says.
2. Maximize available MACRA educational resources.
Because physicians want to thrive, get educated about MIPS as part of MACRA. They can't make the right decisions if they don't know what to do. Practices can hire someone to help, but why not start with the comprehensive Centers for Medicare & Medicaid Services (CMS) website. Professional organizations have additional help, including the American Medical Association (AMA).
Also remember that if physicians have participated in any of these three programs, the transition will be much easier.
· Physician Quality Reporting Program (PQRS): 2007 – 2016 -> becomes the Quality category in MIPS
· Value-based Payment Modifier: 2015 – 2017 -> becomes the Cost category
· EHR Incentive Program / Meaningful Use: 2011 – 2018 -> becomes the Advancing Care Information category
3. Pick your path of participation.
If physicians currently care for Medicare patients, they may have to choose MIPS instead of participating via an advanced Alternative Payment Models (AAPM). "This is actually the first important decision you need to make," Sage says. For the first year under this new curriculum, most peers are not taking the road less traveled—they are participating in MIPS. Once physicians have made this big decision, they will pick program components and decide what they are going to report on.