Transitioning From Meaningful Use to MACRA/MIPS: What You Need to Know

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THE PRESENT AND FUTURE OF MEANINGFUL USE

WHY IS MEANINGFUL USE TRANSITIONING TO MIPS?

Meaningful Use is a Medicare Quality Program aimed at lowering the cost of healthcare and helping providers offer better care without sacrificing their bottom line. Currently, EHR Meaningful Use essentially involves implementing software to advance your practice and patient care through it’s reporting system. Moving forward, Meaningful Use will be renamed as “Advancing Care Information” and combined with other Medicare Quality Initiatives into one system. This sole system, known as MIPS, stands for “Merit-based Incentive Payment System”, and is part of the Quality Payment Program (QPP). For security purposes, the EHR and Meaningful Use software continues reporting through MACRA program through MIPS.

WHAT IS MACRA?

In October of 2016, CMS released the final rule implementing The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). MACRA established the Quality Payment Program (QPP), providing new ways to pay physicians for caring for Medicare beneficiaries. The QPP has two paths: Advanced Alternative Payment Models (APMs) or MIPS.

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SHOULD I FOLLOW THE MIPS OR APM TRACK?

MIPS: : You must report if you exceed the threshold by treating 101 or more Medicare patients and billing more than $30,000 in allowable charges. You also must be a physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist. If it is your first year in Medicare or you do not meet the threshold, you can be exempt or you can practice and voluntarily report, and there may be a benefit depending on what providers do in 2017. This is the first time Medicare has allowed providers to attempt to learn this system in test mode. Just submitting a few codes in one Quality measure will prevent the 2019 fee penalty and there are many opportunities to possibly earn more than a 4% fee increase for 2019.

APM: You will only qualify for the APM track if you are a part of an ACO (Accountable Care Organization). Most chiropractors will participate in the MIPS track, but if you are an Advanced APM, you can visit the QPP website to learn more.

SUBMITTING INFORMATION FOR MIPS

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With MIPS software, you can earn a payment adjustment based on evidence-based and practice-specific quality data substantiating that you provided high-quality, efficient care supported by technology. Information should be submitted in these categories:

QUALITY REPORTING (PQRS)

What You Need to Provide

A minimum of 90 days of MIPS data, claims with G-codes, or six clinical quality measures (CQM), including one functional outcome measure.

BENEFITS

Ninety-day reporting in this category may allow providers to avoid penalty if they report on two measures if they are available. Reporting for a full year could result in a positive 4% payment adjustment, and a larger amount of points may be awarded based on achieving higher performance in the measure. You must report one quality measure to avoid penalty or choose one measure from any other category.

ADVANCING CARE INFORMATION (MEANINGFUL USE)

What You Need to Provide

A minimum of 90 days of data, complete required CQM measures, and bonus reporting. Specialties may be excluded from certain measures that do not apply. You must report one required measure to avoid penalty or choose a measure in another category.

BENEFITS

Ninety-day reporting in this category may allow providers to avoid penalties or qualify for a small incentive. Reporting for a full year could result in a positive 4% payment adjustment.

CLINICAL PRACTICE IMPROVEMENT

What You Need to Provide

A minimum of 90 days of data and four improvement activities from the CMS list of suggested activities. The four improvements should fit your specialty and practice type. Make sure you report one improvement to avoid a penalty or choose a measure in another category.

BENEFITS

Reporting for improvements could result in a positive 4% payment adjustment. Bonus categories include use of CEHRT to complete CPI.

YOUR TRACKS FOR PARTICIPATION

When using MIPS software data, you can earn a payment adjustment based on evidence-based and practice-specific quality data substantiating that you provided high-quality, efficient care supported by technology. You can pick your track by either reporting something on at least one of the categories to avoid a penalty, reporting for at least 90 days to meet the full standards and gain a modest fee increase, or report a full year to possibly gain a bigger increase in 2019 fees. If you’re concerned about complying with MACRA, Software solutions like ChiroTouch can help to manage it for you.

DoNotParticipate

NOT PARTICIPATING

You will receive a negative 4% payment adjustment.

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SUBMIT SOMETHING

Submit just one measure in any category, you can avoid a downward payment adjustment.

SubmitAPartialYear

SUBMIT A PARTIAL YEAR

If you submit 90 days of data, you may earn a neutral or small positive payment adjustment.

SubmitAFullYear

SUBMIT A FULL YEAR

You may earn a moderate positive payment adjustment.

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Learn valuable insights and best practices regarding the transition from Meaningful Use to MACRA/MIPS.

VIDEO SERIES – TRANSITIONING FROM MEANINGFUL USE TO MACRA/MIPS

In this video series you can find information to help you keep up to date on the latest MACRA/MIPS news.

Introduction To The “Transitioning From Meaningful Use to MACRA/MIPS” Video Series

Jenn Hay, ChiroTouch’s Certified Meaningful Use and Audit Specialist, introduces the video series Transitioning From Meaningful Use to MACRA/MIPS. The series will explore the current state of Meaningful Use reporting and what to expect as the reporting process becomes part of MACRA/MIPS.

Episode 1 – What Does It Mean To Use Your System Meaningfully?

What does it currently mean to be a meaningful user and what will it mean to be one moving forward? ChiroTouch’s Certified Meaningful Use and Audit Specialist,  Jenn Hay, unpacks the answers to several important questions you should be asking yourself about participation in the new MACRA/MIPS reporting process.

Episode 2 –  What It Means To Participate In The New Program

Jenn Hay, ChiroTouch’s Certified Meaningful Use and Audit Specialist, explains the current state of Meaningful Use reporting. Why has the program been scaled back? Do you understand how to maintain security compliance in current and future reporting? Get the answers to those questions and more in this episode.

INFORMATION & RESOURCES

Below you will find links to official information and resources to help you prepare for the transition from Meaningful Use to the Quality Payment Program (MACRA/MIPS).

Read the Official Rule

Learn more about the Quality Payment Program (MACRA/MIPS) final rule.  (UPDATED 10.14.2016)

MACRA Legislation

Read the official Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

Additional Information & Resources

(UPDATED 10.14.2016 – 10.26.2016))

WEBINARS

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