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MACRA, MIPS, and APMs — Are You Ready?: Page 2 of 3

MACRA, MIPS, and APMs — Are You Ready?: Page 2 of 3

• The performance score consists of additional points awarded for certain objectives (maximum of 50 points). CMS focuses the performance score on the Stage 3 Patient Electronic Access, Coordination of Care through Patient Engagement, and Health Information Exchange objectives. Here providers can report on the measures in which they perform best.

• Removes the "Clinical Decision Support" and the "Computerized Provider Order" measures since these are consistently above 90 percent and therefore considered widely adopted. It also reduces the number of measures to an all-time low of 11 measures, down from 18 measures, and no longer requires reporting on the "Entry" measure.

• Simplifies reporting requirements for "Health Information Exchange" and "Public Health and Clinical Data Registry" reporting measures to a simple yes/no attestation.

• Eliminates the 90-day reporting period for first-time attestations, instead requiring a full calendar year reporting period for all stages and all providers.

3. Continue to participate in PQRS

This makes you subject to the Value-Based Modifier. Review your practice's Quality and Resource Use Reports (QRURs) for the 2014 period as well as the first part of 2015. Your QRUR will show you how you are being rated on both cost and quality and where you may need to make adjustments.

4. Monitor your profile on the Physician Compare site

Physician Compare is based on your QRUR data. This information is made readily available to the public as a means for consumers to select providers who meet and exceed CMS' quality measures. See how you are currently performing and adjust as necessary to optimize your score.

If you are not already participating in a patient clinical data registry, contact your specialty society about participating in theirs, as data registries can streamline reporting and assist with MIPS performance scoring.


If you practice chooses to participate in an Alternative Payment Model (APM) rather than MIPS, here are two key points to consider:

1. Transitioning to a new payment entity

In addition to MIPS, MACRA has created new opportunities for physicians to develop and participate in alternative payment models, or APMs.

If you participate in an Accountable Care Organization (ACO), Clinically Integrated Network (CIN), or other entity that applies and qualifies as an APM, contact your entity's administrators to ascertain what plans are being made to meet the new model. Even though quality measures and criteria are still being defined by CMS, most organizations are already planning a clear direction.


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