The time has come for us to say goodbye to 2016 and usher in a new year. In doing so, we say goodbye to traditional quality programs (Meaningful Use Incentive Program, Physician Quality Reporting System [PQRS] and Value-Based Modifier System [VM]) and begin work on the new Medicare quality program, the Merit-Based Incentive Payment System (MIPS). If you have managed to miss any of the hundreds of emails or hours of speakers talking about MIPS or MACRA, this new quality program brings the MU, PQRS and VM program together with a few new items under one quality incentive program.
As we head into the New Year, I want to highlight a few important action items you need to know for 2017.
- Providers are now eligible to report for 90 days of MU for 2016. Providers have until February 28th to report for Medicare and March 31st to report for Medicaid.
- 2016 is the LAST year to apply to the Medicaid MU program. You have until the end of March (subject to change) to submit an AIU for 2016. If a provider enrolls for 2016, they can still obtain the full six years of MU payments through the Medicaid program.
- Providers participating in the Medicaid MU program must also take part in the new MIPS program (or through an Advanced Alternative Payment Model APM if applicable). This means you will still report MU in 2017 to the state of Kentucky AND will report 2017 data to Medicare.
- Reporting for MIPS in 2017 can be for a full year, 90 days or one single quality measure, each with a separate incentive payment structure. If you report for a full year, you MUST have all pieces in place for each component before the start of the reporting period (i.e. portal turned on, direct secure messaging enabled, etc.).
- Practice Improvement Activities is a new category to MIPS and utilizes new measures that align with the Patient Centered Medical Home Model. There are 90 measures to choose from and depending on the size and location of your practice, you report between two to six measures.
- If you don’t report MU for 2016, you will see a negative payment adjustment in 2018. If you don’t report MIPS at any level in 2017, you will see a negative payment adjustment in 2019.
- Stage 3 MU measures, newly named to Advancing Care Information, will become required in 2018. Additionally, having a 2015 certified EHR system will be required in 2018. Use 2017 to become familiar with the new measures and to begin using the new measures in your quality reports and ensure your EHR system is upgraded to the certified platform.
This list is not all encompassing but provides you some of the most important action items to be aware of as we move into the new year. Contact NeKY RHIO for more information on each of these items, where to find specific information, a tailored action plan as well as education and training on any quality incentive program. Don’t worry about learning all there is to know about MIPS and MACRA, because NeKY RHIO can provide you with information specific to your practice.