While the implementation of the Quality Payment Program (QPP) within the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) may seem daunting, the program does offer some data capture and reporting relief to practices. MACRA takes elements from three existing Centers for Medicare and Medicaid Services’ (CMS) programs—the Physician Quality Report System (PQRS), the Electronic Health Record Incentive Program (commonly known as Meaningful Use or MU) and the Value-Based Modifier (VBM)—and consolidates them to one QPP avenue: the Merit-based Incentive Payment System (MIPS). This means that practices have less overall data to capture, track and report.
Ready or not, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program (QPP) and its associated financial incentives and penalties start next year. Unlike previous pay-for-performance programs, the Centers for Medicare and Medicaid Services (CMS) has done away with “all or nothing” rules for earning payment adjustments with the QPP’s Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM).
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a major piece of legislation that contains two value-based care programs that will affect nearly all physicians: the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APM).
The 2,398-page final rule for the Medicare Access and CHIP Reauthorization Act (MACRA) was released in October. In the wake of this new ruling, a survey conducted by Medscape found that nearly 30 percent of physicians had never heard of MACRA as recently as mid-September. This seems like a large number of physicians who are still in the dark, considering that the law could positively or negatively affect their Medicare reimbursements by as much as nine percent.
On March 20, 2015, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Stage 3 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Stage 3 raises the bar for all providers, increasing some existing threshold measures from Stage 2 and proposing aggressive timelines for attestation. The new rules require providers to meet rigorous qualifications, and all eligible Medicare and Medicaid providers (EPs) must attest to meaningful use Stage 3 by 2018. While financial incentives are tapering off for meaningful use, the implication is clear. The penalty phase is about to begin in earnest. Starting in January 2015, nearly 257,000 eligible professionals (EPs) – or half of all EPs - will face a one percent cut to their Medicare reimbursements for not meeting meaningful use standards, according to CMS.
Providers as well as health care organizations have eagerly waited for the Centers for Medicare & Medicaid Services to reveal the stage 3 requirements for meaningful use under the Health Information Technology for Economic and Clinical Health Act. On March 20, the organization finally released the proposed rule for stage 3.
The meaningful use program was designed by the Centers for Medicare and Medicaid Services with the aim of improving the efficiency, security and quality of EHRs. It has gone through some ups and downs as well as some delays since it began in 2011. Meaningful use stage 2 has been extended through 2016, and stage 3 has been delayed until 2017. At that point, providers who have completed at least two years of stage 2 can begin the next level of attestation. Many providers, however, know little about the third and final part of the CMS incentive program.