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November 5, 2016

MACRA Final Rule Published – And here’s what we know about it!

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A little over two weeks have passed since the early announcement of the MACRA final rule and we are well underway with studying the 2171 page document.  While we are working on committing the entire document to memory, I wanted to go ahead and share some key changes from the proposed rule regarding MIPS eligible clinicians.

3 Categories in 2017

The cost category that is based on the Value Based Modifier Program and utilizes the QRUR report will not be included in the 2017 calculation of your composite score. This will be calculated in 2018 so don’t completely write off this category – just don’t worry about it for the upcoming year.

Category Weight

The category weights for determining the composite score have changed for each category to account for the removal of the cost category in 2017. The 2017 weights are as follows:

  • Quality: 60%
  • Advancing Care Information: 25% (Meaningful Use)
  • Improvement Activities :15% (Clinical Practice Improvement Activities, aka CPIA)

 Quality

Only report on 6 measures that includes an outcome base measure. Requirements for the cross-cutting measure has been eliminated.

Timeline

For MIPS eligible clinicians, there are three reporting options:

  • Report for the full year to earn a moderate payment adjustment.
  • Report for 90 days and receive a neutral or small positive payment adjustment.
  • Submit a minimum amount of data and you can avoid a downward payment adjustment.
  • You will only receive a negative payment adjustment if you do not participate in the MIPS or APM and report nothing or less than the minimum to CMS.

Performance Period

The performance period is tied to the calendar year and depending on which reporting option a provider chooses, they can begin anytime from January 1-October 2.

These are some of the priority changes but there are many others that are provider or clinic specific. Contact NeKY RHIO for direct assistance in navigating the MIPS program at 1-855-385-2089.  And keep watching our Facebook page and blog for continuous information on MACRA as you prepare for 2017.

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