Jan 23, 2017

MACRA: Prepare Now and Get Paid More Later

January 23, 2017 by Alanna Diffendal  |  Updated May 24

A doctor stands and uses a tablet

MACRA is a term being thrown around by many in the healthcare industry, but there is still confusion around who will be impacted and what the upcoming requirements will look like for medical physicians across the country.

At a high level, MACRA has shaped the new Quality Payment Program that will begin in 2017. By participating in The Merit-based Incentive Payment Systems (MIPS) or the Advanced Alternative Payment Models (APMs) you can have a positive impact on your payment adjustments in 2019.  

Note: This blog will focus on the MIPS track.

Determining whether or not you are a part of the MIPs program can be confusing, which is why CMS has published a list of requirements. Click here to view the requirements.

You are eligible to participate in MIPS track of the Quality Payment Program if you bill more than $30,000 to Medicare, and provide care to more than 100 Medicare patients per year, and you are a:

  • Physician
  • Physician assistant
  • Nurse practitioner
  • Clinical nurse specialist
  • Certified registered nurse anesthetist

If 2017 is your first year participating in Medicare, then you do not qualify for the MIPS track of the Quality Payment Program.

If the above criteria applies to you, participation in MIPS can result in a payment adjustment of up to 4% and by not participating in MIPS you will receive a negative payment adjustment of 4%. It is important to get started now with a certified electronic health record solution (EHR), like RXNT|EHR, because the amount of data you submit for MIPS in 2017 will determine the amount of your payment adjustment in 2019. Prepare now and get paid more later!

To learn more about the measures you will need to meet for MIPS, click here for an overview: https://qpp.cms.gov/mips/quality-measures.

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