The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), signed into law in April, not only repealed the Medicare sustainable growth rate (SGR) formula, it also contained other provisions that will impact how physicians deliver care. |
Medicare payment rates will be stableThe bill also provides for positive payment updates of 0.5 percent, starting July 1 this year and then on Jan. 1 annually through 2019.
MACRA prevented an impending physician payment cut under the SGR and increased the Medicare conversion factor, part of the formula for calculating physician payments. As a result, Medicare physician pay this year will be 27 percent greater than under SGR.
Quality reporting programs will be consolidated
Medicare's current quality reporting programs will be simplified into one merit-based incentive payment system, referred to as "MIPS." This means the current penalties under the Physician Quality Reporting System (PQRS), meaningful use electronic health record (EHR) program, and the value-based payment modifier will expire at the end of 2018 and will be replaced with the MIPS. Performance under the MIPS will be based upon four categories—quality, resource use, meaningful use, and clinical practice improvement activities. The MIPS also would build and improve upon current quality measures and concepts in existing programs.
Physicians will be encouraged to report quality measures through certified EHR technology or qualified clinical data registries. Participation in a qualified clinical data registry would also count as a clinical practice improvement activity. Alternative payment models will be rewarded--physicians who participate in qualified alternative payment models will receive a 5 percent bonus starting in 2019. These physicians also will be exempt from participating in MIPS. Technical support will be provided to help smaller practices participate in alternative payment models.
Physicians will have liability protections.
The bill contains a provision similar to the Standard of Care Protection Act that will protect physicians by preventing quality program standards and measures (such as PQRS or MIPS) from being used as a standard or duty of care in medical liability cases.
Learn more about how MACRA will impact physicians on the American Medical Association's new Web page on Medicare physician payment reform, including fact sheets on the impact of MACRA in each state.
CMS to Host Physician Compare Informational WebinarDuring this session, CMS will answer questions about Physician Compare and public reporting, but the agency is requesting that participants submit their questions in advance of the webinar. All questions must be received by 5 p.m. Eastern time June 15.
The Centers for Medicare & Medicaid Services (CMS) will host a webinar to discuss the Physician Compare program from 1-2 p.m. ET on June 23.
To register or submit a question, send an email to PhysicianCompare@Westat.com. Please use the subject line "Physician Compare Virtual Office Hour" and include your name, organization, telephone number and email address. For more information, visit CMS's Physician Compare Initiative Web page.
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