Resources on MACRA
the Medicare Access and CHIP Reauthorization Act of 2015
What should you be doing right now?
Pick your pace now in 2017 to avoid a penalty.
What is MACRA?
The Medicare Access and CHIP Reauthorization Act (MACRA) is a law signed by President Obama in 2015. MACRA:
- Repeals the sustainable growth rate (SGR) methodology for determining updates to the Medicare physician fee schedule.
- Establishes annual positive or flat fee updates for 10 years and institutes a two-track fee update beginning in 2019.
MACRA - Top Changes for 2018
Small Practice and Complex Patient Bonuses – Small practices (15 or fewer clinicians) will receive a 5-point bonus added to their MIPS final score. ECs can also earn up to 5 bonus points for providing care to complex patients.
Increased Low-Volume Threshold – Eligible clinicians (ECs) who provided care to less than or equal to 200 Medicare Part B beneficiaries or received less than or equal to $90,000 in Medicare Part B payments are excluded from MIPS.
Longer Performance Period – The performance period for the quality and cost categories is a full calendar year (January 1, 2018-December 31, 2018). The performance period for the advancing care information and improvement activities categories is any consecutive 90 days.
Data Completeness – In the quality category, ECs must report on at least 60% of patients, regardless of payer, eligible for the measure.
Cost Will Be Scored – The weight of the cost category has increased to 10% for the 2018 performance period. The weight of the quality category has decreased to 50%.
Virtual Groups Available – Solo and small practices (10 or fewer clinicians) can join together to participate in MIPS as a virtual group.
Realize Payment Now
Steps you can take now to get paid.
- Annual Wellness Visits (AWV) -- Implement AWV to optimize revenue and improve Medicare quality and cost with minimal impact to your practice.
- Chronic Care Management (CCM) -- You and your team invest in caring for patients with chronic conditions. Get paid for it with CCM while also preparing for MACRA--without adding extra work.
- Transitional Care Management (TCM) -- Get paid for the time you invest in coordinating your patients' transition.
- Advance Care Planning (ACP) -- Guide your patients through end-of-life decisions and learn how to get paid for it.
Making Sense of MACRA Series
- Medicare Payment Reform -- From Family Practice Management
- Value-based Payment and Your Future -- From Family Practice Management
- The Big Picture(4 page PDF)
- Using Data to Prepare(6 page PDF)
- Understanding Your Pathway(3 page PDF)
- Get Paid With the Annual Wellness Visit (AWV)(3 page PDF)
- Pick Your Pace(2 page PDF)
- The Value of Quality and Cost(4 page PDF)
- Advancing Care Information (ACI) and Improvement Activities (IA)(4 page PDF)
- Simplifying Chronic Care Management (CCM)(1 MB PDF)
- A Guide for Employed Physicians(1 MB PDF)