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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.

CMS infographic, 2018

 

Timeline for MIPS and Advanced APM Participation

CMS Infographic, 2016.

CMS infographic, 2016

General Information

Educational Resources

Upcoming Webinars and Past Presentations

Title Date Registration
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

 

America’s Essential Hospitals regularly compiles resource pages to inform our members and other stakeholders about timely issues.