The Centers for Medicaid and Medicare Services (CMS) developed Meaningful Use requirements to encourage Providers to implement a Certified Electronic Health Records Technology (CEHRT). The long-term goal of Meaningful Use is that all healthcare information from patient records to encounters will be interoperable, making it easier for Providers to care for patients in the future.
2018 Meaningful Use Changes You Need to Know
- 2015 Edition CEHRT Bonus
- Payment Adjustment Increases to -/+ 5%
- Low Volume Threshold Increases
- Performance Threshold Increases from 3 to 15
- Cost Category Takes Effect
- Virtual Groups Participation Becomes Optional
- Hardships & Unforeseen Circumstances Exclusions in Place
- Small Business Accommodations & Incentives
Click here to learn more about 2018 Meaningful Use Changes.
The Medicare Access and CHIP Reauthorization Act, more commonly referred to as MACRA, shaped the new incentive program which combines previously known programs including Physician Quality Reporting System (PQRS), Value-based Payment Modifier, and Meaningful Use (MU). Eligible Clinicians (EC) should be aware that reporting periods for the current year will be reflected in your pay-out two years after. This 2017 change meant that reporting for the first performance year in 2019 began. Come 2019, you will either receive incentives or penalties from your participation in MACRA from 2017.
How Do I Know If I Qualify For MACRA?
- Does your practice have $90,000 ≥ in Medicare charges AND 200 ≥ fewer Medicare patients annually?
- If the answer is yes, you can relax and take a deep breathe because you are exempt from MIPS participation
- If the answer is no then you qualify for MIPS or potentially APM
Have your NPI number ready? Click here to determine your participation status.
- Does your practice participate in an Accountable Care Organization (ACO), Clinically Integrated Network (CIN) or another entity that applies and qualifies as an APM?
- If the answer is yes to both questions, then you qualify for not only MIPS but APMs as well
- If you answered yes to number one and no to number two, then you only qualify to participate in MIPS
- If neither but you participate in another APM entity, contact your entity’s administrators
The Merit-based Incentives Payment System (MIPS) is designed to help EC benefit from implementing a CEHRT. MIPS allows practices to choose their own rate of participation – positive, neutral, and negative adjustments – that must be reported on in 2017, to see results in 2019. These 3 categories include:
- Quality – 50%
- Advancing Care Information – 25%
- Improvement Activities – 15%
- Cost – 10%
Each category has a specific number of measures that must be met, which collectively display your MACRA score that affects your payout in 2019.
How will my participation this year affect me in the future?
Your participation score for this year (2018) will start affecting your practice in 2020 between -/+ 5%. This percentage will increase over time:
To learn more about MACRA/MIPS check out these related posts: