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Three Tools To Help Navigate MACRA - MIPS & APMs

Posted by Julie - on Thu, Oct 26, 2017

Are there enough acronyms in that title? WOW… healthcare today requires knowledge of its Alphabet Soup and a lot of deciphering of the requirements. However, one thing we know for sure is having the right tools and accurate clinical documentation is critical to obtaining reimbursement. Overwhelmed? Here are three tools to help in your success: 
  1. Dragon Speech Recognition Software
    Don’t waste time typing. Getting trained in the expedience of Dragon software will have you updating EHR measures in no time. This allows you more time to provide quality care to your patients. Schedule a DEMO to see how effectively Dragon works in all applications.
  2. Helpful Acronym Definitions

    MACRA – Medicare Access and CHIP Reauthorization Act
    HHS – Health and Human Services
    QPP – Quality Payment Program
    MIPS – Merit-Based Incentive Payment System (Replaces the Sustainable Growth Rate (SGR) formula)

MIPS FINAL.png
  1. Quality – Replaces Physician Quality Reporting System (PQRS) Requires reporting on six quality measures, or one specific or subspecialty specific measure set.
  2. Clinical Improvement Activities – New Category - Four medium weighted or two high-weighted activities to receive full credit.
  3. Advancing Care Information – Replaces Meaningful Use (MU) Using Certified Electronic Health Record Technology (CEHRT) report on five required measures.
  4. Cost – Replaces the Value-Based Modifier (Will be calculated in 2017, but will not determine payment adjustment until 2018.)

  1. APM – Alternative Payment Model
    AAPM– Advanced Alternative Payment Mode
    EC – Eligible Clinician
    ACI – Advancing Care Information

  1. All of these can be more clearly defined at:http://www.aafp.org/practice-management/payment/medicare-payment/acronyms.html

  1. Website Help

    There are resources to help define what you need:

    https://qpp.cms.gov
    https://www.healthcatalyst.com/wp-content/uploads/2017/01/Preparing-for-MACRA.pdfhttps://www.gpo.gov/fdsys/pkg/FR-2016-11-04/pdf/2016-25240.pdf

Although it is too late to start reporting for 2017 (the deadline was October 2nd.) It is not too late to start preparing for 2018. The consequences of ignoring QPP reporting are a 4% reduction to Medicare reimbursement (starting 2019) and more importantly, reputations are at stake, as quality scores will be made public. 

Know the intent of MACRA is not just to save money but also to take care of patients efficiently and give them the best quality care. It is about value over volume.