Resources on MACRA
the Medicare Access and CHIP Reauthorization Act of 2015
Report Your 2017 MIPS Data
Report your 2017 MIPS data by March 31, 2018, to avoid a negative 4% Medicare B payment adjustment in 2019.
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
- Time to Report 2017 Data(143 KB PDF)
- Medicare Payment Reform -- From FPM Journal
- Value-based Payment and Your Future -- From FPM Journal
- 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)
Articulating the Value of Family Physicians
Under MACRA, Medicare and other payers will increasingly pay physicians based on the value rather than the volume of their services. The AAFP is helping family physicians communicate this with payers and employers with this literature review. It provides a coherent argument, including references and an annotated bibliography, for why family physicians are invaluable assets in the health care system and for the benefits of having family physicians in a central leadership role within value-based payment systems.