Medical Practices Alert! Are you ready for January 2017?

The year 2017 is just around the corner and medical practices across the US are gearing up for the new healthcare act. The Quality Payment Program, as part of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) implementation, contains several subtleties that may prove to be useful for eligible clinicians in the successful participation for either the Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS) coming January.

Although the APM is more profitable, but it comes with high benchmarks and thus majority of the physicians will find themselves falling in the MIPS program. The times are tough especially for practices who are already nose deep in catering to their daily patients and find the new rules a bit too confusing. In order to assist such practices in gauging their eligibility and ensuring their participation in MIPS, many companies such as EMR Systems have launched MIPS Resource Centers through which they conduct webinars and publish whitepapers offering support and educating physicians about the new rules.

Now MIPS requires physicians to begin tracking certain categories of data from January to October 2017. Doctors will then be needing to report that information to CMS until March 31, 2018. This data is vital as physicians’ Medicare fee-for-service rates will be based on its results. They can increase or decrease as much as 4% starting January 2019 so if you are planning to prepare for it, you better hurry. Also, the percentages will be going up each year after that and will always be established on the information reported for the previous two years. As for physicians who want to report as a group, they will be needing to register as a group with CMS no later than June 30, 2017.

Physicians failing to report the minimum amount of data will be receiving 4% negative adjustment in 2019. For physicians aiming at avoiding the negative adjustment under MIPS there are three options:

Full Reporting:
Full Reporting will require physicians to report all of the required measures for a continuous 90-day period (minimum). Clinicians opting for it will receive a moderate positive payment adjustment based on their score.

Partial Reporting: 
Clinicians opting for partial reporting will receive either a small positive payment adjustment based on their score or no adjustment at all. IN it, physicians will be reporting on more than one improvement activity, or one quality measure, or more than the required measures in the “advancing care information performance category. This will be done on a minimum of a continuous 90-day period.

Minimum Submission: 
Practices opting for this option will not receive any performance bonus, but they will not be subjected to any penalty. Also, they won’t be needing to report on a continuous 90-day period. What they will be required to do will be to report on one activity in the improvement activities category, one quality measure, or the required measures of the advancing care information category.

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