About 91% of clinicians eligible to participate in MACRA's Merit-based Incentive Payment System (MIPS) submitted data in the program's first reporting year—surpassing CMS' goal of 90% participation, CMS Administrator Seema Verma announced in blog post.
Under MACRA's Quality Payment Program, which took effect in 2017, eligible professionals can choose from two payment tracks:
- The Advanced Alternate Payment Model (Advanced APM) track, for clinicians who take on a significant portfolio of Advanced APMs, which include risk-based ACO models; or
- MIPS, for providers who are reimbursed largely through fee-for-service.
Physicians' pay in the MIPS track largely follows a traditional fee-for-service structure—but CMS adjusts eligible professionals' pay based on how they "score" in four categories of metrics: advancing care information, cost, improvement activities, and quality.
CMS deemed 2017 as a "transition year" and required eligible clinicians to submit only 90 days' worth of data. According to RevCycleIntelligence, participating clinicians had the option of submitting data on one quality measure, Improvement Activity, or four or five Advancing Care Information measures to meet MIPS requirements. Beginning in 2018, eligible clinicians will need to report on a full year's worth of data.
Eligible providers who meet those requirements based on their 2017 data will receive penalties or bonuses of up to 4% beginning in 2019. That percentage will increase up to 5% in payment year 2020, and rise incrementally until it reaches 9% in payment year 2022.
Verma in the blog post said 91% of clinicians eligible to participate in MIPS submitted data in the program's first reporting year.
Verma in the post also noted that participation rates for accountable care organization (ACO) and rural clinician participation were 98 percent and 94 percent, respectively.
Verma did not share the number of clinicians who did not submit data and, as such, are likely to face a 4% cut in Medicare reimbursements in 2019, Politico's "Pulse" reports.
According to "Pulse," provider groups also are looking for updates on the number of providers who submitted data based on just one quality measure (Dickson, Modern Healthcare, 5/31; Belliveau, RevCycleIntelligence, 5/31; Slabodkin, Health Data Management, 6/1; Diamond, "Pulse," Politico, 6/1).
5 things everyone should know about MACRA
The implementation of MACRA is the most notable change to Medicare physician payment in over a decade. Passed with bipartisan support, MACRA changes the way Medicare pays clinicians.
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