Doctors may not agree with MACRA, however, refusing to comply will result in financial penalties. The best course of action is to get educated.
On April 16, 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law thereby abolishing the fatally flawed Sustainable Growth Rate (SGR). The goals of this law are multiple: reimburse physicians for quality versus quantity, merge several quality programs into the new Merit Based Incentive Payments System (MIPS), and pay out bonuses for providers who participate in alternative payment models (APMs).
While the roll-out of this new law was met with much confusion, the implementation is perhaps even more mind-boggling for many physicians. Most of us know of bonuses and quality initiatives, but this program promises either positive or negative adjustments based on specific quality measures. Depending on a MIPS composite performance score, a provider will receive positive, negative, or neutral adjustments on their base pay. Even the usual language has changed.
When even the data experts seem to struggle on the implications of MIPS, how are busy providers supposed to understand? Many providers are employed by hospitals or large groups who have departments dedicated to the task. Doctors in small practices don’t have anyone but themselves to do it. Yet, it is imperative to learn to avoid being financially penalized (the true meaning of the phrase “negative adjustment”).
What doctors need to know about MACRA/MIPS?
While many doctors opposed the passage of MACRA, it appears that it is here to stay. We may not agree with its provisions, however, if we refuse to comply, we will be hit with financial penalties. The best course is to get educated and get paid the money we deserve.