MACRA Physician Payment Resources for Essential Hospitals
The Centers for Medicare & Medicaid Services (CMS) final rule on the Medicare Access and CHIP Reauthorization Act of 2015 established a new approach to physician payment: the Quality Payment Program (QPP).
MACRA consolidated into the QPP three existing physician quality programs: the physician quality reporting system, the Medicare Electronic Health Records Incentive Program for eligible professionals, and the value-based payment modifier. Eligible clinicians will be required to participate in one of two tracks established under the QPP: the default merit-based incentive payment system (MIPS) and the advanced alternative payment models (APMs).
During the first performance year of the QPP — calendar year (CY) 2017, the “transition year” — physicians will be able gain experience with the program by setting the pace of their participation. To avoid negative payment adjustments in CY 2019, eligible clinicians have three options to submit data to MIPS, outlined below, as well as a fourth option to join Advanced APMs. Clinicians who do not participate in the QPP (that is, they do not report any data to CMS) will incur the full negative 4 percent payment adjustment in CY 2019.
Timeline for MIPS and Advanced APM Participation
- Medicaid payment arrangements that qualify as Other Payer Advanced APMs
- CMS Finalizes CY 2018 Updates to Quality Payment Program
- Quality Payment Program Hardship Exception Application for the 2017 Transition Year
- Predictive Qualifying Alternative Payment Model (APM) Participants (QPs) Methodology Fact Sheet
- Quality Payment Program Overview Fact Sheet
- Merit-based Incentive Payment System (MIPS) Overview
- Alternative Payment Models (APMs) Overview
- Quality Payment Program 2018 MIPS Cost Performance Category Web-Based Training Course — New
- Quality Payment Program 2018 MIPS Improvement Activities Performance Category Web-Based Training Course — Revised
- Quality Payment Program 2018 MIPS APMs Web-Based Training Course — Revised
- Quality Payment Program 2018 Advanced APMs Web-Based Training Course — Revised
- Technical Assistance Resource Guide
- Identification Tool for MIPS Participation Status
- Merit-Based Incentive Payment System (MIPS): 2017 CMS-Approved Qualified Registries
- MIPS Improvement Activities Fact Sheet
- Where do I go for help with the Quality Payment Program?
- Alternative Payment Model (APM) Design Toolkit
- APIs for the Quality Payment Program
Upcoming Webinars and Past Presentations
|Quality Payment Program Year 3 Final Rule Overview Webinar||November 15, 2018||Register|
|CMS Innovation Center Medicare Quality Payment Program Year 2 Final Rule – All-Payer Combination Option Webinar||November 29, 2017|
|Information on Field Testing Activities (Same content as Oct. 30)||November 2, 2017|
|October 30, 2017|
|MIPS Advancing Care Information Deep Dive Webinar||April 4, 2017||Download slides|
|Introduction to the Merit-base Incentive Payment System (MIPS)||February 9, 2017||Watch video|
|Introduction to Advanced Alternative Payment Models (APMs)||January 19, 2017||Watch video|