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MACRA to Hit Small Practices Hard: Page 2 of 3

MACRA to Hit Small Practices Hard: Page 2 of 3

2. This rule applies only to physician practices and to Medicare

For now, only physician offices—not hospitals—are governed by MACRA rules. Acting Administrator of CMS, Andy Slavitt said in a press call that hospitals will be addressed in the coming months. In addition, this program only applies to payments physicians receive from Medicare. Medicaid is not included. This also means for physicians who are eligible for Meaningful Use and other programs under Medicaid, those programs would presumably continue.

3. Meaningful Use is no more in 2017

However, the Advancing Clinical Information category aligns and modifies the 2015 EHR Certification Stages 2 and 3 Meaningful Use measures with focuses on interoperability, patient engagement, etc.. The big difference is the thresholds from those Meaningful Use requirements have been either significantly lowered or eliminated, and reportedly, the "all-or-nothing approach" has been axed. There is half credit for simply attesting. Still, through "Advancing Clinical Information," Meaningful Use lives on.

4. There is a one-year reporting period

There has been a lot of controversy over whether or not Meaningful Use should be reported by physicians through a one-year period or 90-day period. In MIPS, the proposed rule has the reporting period at a full year, which will most definitely be met with contention from advocacy groups.

5. Most physicians will start with MIPS

All physicians — with a few exceptions—will report through MIPS in the first year of the program. That data will then be used by CMS to determine which providers met the requirements for the APM track. Physicians are not locked into their choice — they can switch between MIPS and APM annually.

6. How the four categories are weighed will change

Here's how the scoring of the four categories will change over the years:


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