Have you heard about the new Medicare payment reforms and Quality Payment Program?

Do you know how this will affect you?

How does the Merit-based Incentive Payment System (MIPS) work?

Why should you participate?

Effective November 1, 2016, the Centers for Medicare and Medicaid Services (CMS) finalized the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This new rule implemented a program that is intended to improve care for Medicare beneficiaries as well as impact Part B reimbursements. Although the Quality Payment Program (QPP) is voluntary, participating eligible clinicians will be impacted by the specific data reporting requirements, new practice models, evolving practice standards and physician evaluations. Most physicians (90+%) will participate in the Merit-based Incentive Payment System (MIPS) path; the other 10% of physicians will participate in an Advanced Alternative Payment Model (APM). These new reforms replace Meaningful Use and the Physician Quality Reporting System (PQRS).

You can start collecting performance data that records the quality of care you performed and the technology you used to support your practice on or after January 1, 2017. Eligible clinicians who are not ready on January 1st can choose to start anytime between January 1, 2017 and October 2, 2017. However, if you collect data for less than the entire year in 2017, this could affect your score that determines how much your payment incentive will be. Then, by March 31, 2018, send in your data from 2017 to MIPS.

Your practice can earn a payment adjustment based on evidence-based and practice-specific quality data. In 2017, the MIPS Performance Score will have measures in Quality (60%), Advancing Care Information (25%) and Improvement (15%). The Quality measure replaces the Physician Quality Reporting System (PQRS) and requires only 6 quality measures, but it increases reporting on 80% of all patients, not just those with Medicare. Advancing Care Information replaces Meaningful Use where you can choose to submit up to 9 measures. Finally, Improvement Activities is a new category and measures 4 activities.

Participating physicians will avoid Part B payment reductions and possibly receive payment increases in 2019 and thereafter ranging from 4% to 9%. You will also be able to share your composite MACRA score and scores for each MIPS category, through various channels, allowing you to gain a marketing advantage with your patients. Participant quality scores will be available to the public on CMS’s website at www.medicare.gov/physiciancompare/search, so your patients will know what you are doing to improve care and outcomes. It is also reasonable to expect observers like Healthgrades, medical carriers and employee benefit managers to communicate with their consumers who are participating to improve patient quality and outcomes. By choosing to participate, you will not only attract patients but could also gain positive traction with prospective partners, capital financing, payer contract negotiations and future employment opportunities.

Oasis Practice Solutions, Inc. can provide a fully integrated solution to simplify the collection and reporting requirements to fully participate in the QPP. Our solution includes features, such as a patient portal, Patient-Centered Medical Home pre-validated modules and Chronic Care modules to not only help you run your practice more efficiently, coordinate care, empower your patients and increase your revenue, but using them will directly and positively impact your MIPS total performance score.