Complying with MACRA
Helping You Comply with MACRA in Today’s Health Care Environment
Background: Signed into law in 2015, the Medicare Accessibility and CHIP Reauthorization Act (MACRA) introduces several changes to the current physician reimbursement framework. Physicians who participate in a traditional Medicare fee-for-service will earn a performance-based payment adjustment to their Medicare payment through the Merit-Based Incentive Payment System (MIPS).
The performance period for MIPS begins January 1, 2017 and the first payment adjustments will be applied in 2019. All measure data must be submitted to the Centers for Medicare and Medicaid Services (CMS) by March 31, 2018.
IAC Accreditation Can Fulfill Portions of MIPS Performance Measures
Physicians that decide to participate in MIPS will earn a Medicare payment adjustment based on practice-specific quality data for providing high-quality, efficient care through success in four performance categories. The IAC Quality Improvement (QI) Tool and IAC Maintenance of Certification (MOC) activity are options that may be used to satisfy the Improvement Activity component.
|I.||Quality [Replaces the Physician Quality Reporting System (PQRS)]|
|II.||Advancing Care Information (Replaces the Medicare EHR Incentive Program, also known as Meaningful Use)|
|III.||Improvement Activities (Often referred to as Clinical Practice Improvement Activities (CPIA) (New category)
In this new performance category for 2017, clinicians are rewarded for care focused on care coordination, beneficiary engagement, and patient safety.
|The IAC QI Self-Assessment Tool or the IAC QI MOC Activity satisfy the requirements of this category.|
|IV.||Cost (Replaces Value-Based Modifier)
CMS Reporting of MIPS Improvement Activity ID
MIPS Data Submission Options
For both individual and group reporting, attestation is one method of data submission to CMS for the Improvement Activities category. Individual physicians or groups may submit data in multiple mechanisms as outlined in the Federal Register, however the same identifier and same submission mechanism must be used per category. QI meeting minutes must document that 90 days of the quality improvement methods/processes/activities implemented have occurred to receive credit for this activity. IAC will serve as the repository for this data and will provide information about the attestation submission to CMS once this information becomes available.
More information about the MIPS data submission methods are outlined in the Federal Register. (42 CFR) pages 312 and 313 at the following link: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-25240.pdf?1476993567
The IAC is committed to assisting participating facilities to ensure clinicians within accredited facilities earn credit under MIPS for their quality efforts. For further assistance from the IAC related to satisfying components of quality initiatives through IAC accreditation, contact firstname.lastname@example.org.
- MACRA FAQS - Reference from CMS Quality Payment Program (qpp.cms.gov)
- IAC Accreditation and MACRA: Using the IAC QI Tool and MOC Activity to
Satisfy Improvement Activities Under MIPS
- IAC QI Self-Assessment Tool - The IAC QI Self-Assessment Tool is a free feature, created to help your facility document and analyze continuous process improvement and meet the quality measures required by the IAC diagnostic imaging accreditation programs (Vascular Testing, Echocardiography, Nuclear/PET, MRI, CT and/or Dental/CT).
- IAC QI MOC Activity - A Quality Improvement (QI) self-assessment activity to provide interpreting physicians with an online tool to assess quality metrics as required by the IAC Standards and Guidelines.
- The CMS website provides a MIPS Overview page with a tool to browse the different MIPS measures and activities (https://qpp.cms.gov/measures/
performance) as defined for 2017 MIPS Performance.