MEDICAL PRACTICE CONSULTING

The Quality Payment Program final rule is out. Based on updated requirements from the proposed rule, the Centers for Medicare and Medicaid Services (CMS) estimate that between 592,000 and 642,000 eligible clinicians will be required to participate in the Merit-Based Incentive Payment System (MIPS) in 2017, and between 70,000 and 120,000 clinicians will participate in Advanced Alternative Payment Models (APMs).

CMS is worried about how few providers understand or are even aware of the Medical Access and Chip Reauthorization Act (MACRA). As the deadline approached in October 2017 CMS found that around 40% of clinicians, and even fewer nurse practitioners, had a solid understanding of the requirements.  MACRA requires that 400,000 eligible providers must start tracking data in order to avoid a financial penalty in 2019.  A recent Integra Connect survey found that most specialty physicians have not yet made the operational changes necessary to succeed in the new world of value based care.

CMS is actively trying to figure out better ways to get the word out and to make educational tools more accessible, but at the end of the day providers must do their homework on this complex new law.  Medical practices must be prepared if they want to avoid a negatively adjusted reimbursement in this and upcoming years. This is why it is so important to seek additional help with AR computers.  Our healthcare IT services can assist you through the process, and ensure you are prepared for MACRA.

Here are five important aspects of the Quality Payment Program that are different in the final rule from what was previously proposed. You may be glad to learn about some of these changes, since they are likely to ease participation for clinicians next year.  We have reached out to Healthmonix which is a certified registry that we utilize for their “reading list” for our customers:

1The MIPS Resource Library

This page is full of links to webinars, fact sheets, eBooks, and tools that will guide you step-by-step through the complicated world of MIPS. This is a great place to start if you feel like you’re at square one because it offers plain-English explanations of every facet of the reporting requirements, with lots of helpful diagrams and visuals.

2The Quality Payment Program Website

CMS has done a good job laying out the basic information about QPP, MIPS, and APMs on their official QPP website. The site also features a helpful tool that allows you to check your participation status by inputting your NPI number. If you’re not sure about your eligibility status, entering your NPI number to determine your status should be the very next task on your to-do list.

3CMS Webinars and Training Videos

These pages contain links to CMS webinars on the Quality Payment Program, MIPS, and related topics. CMS provides slides, transcripts, and recordings for past webinars.

4QPP Resource Library

This is on the QPP website but still gets its own bullet point because the list of PDF documents and downloads available further down the page is robust and worth perusing in its own right. This page also contains links to the official 2017 rule, and the proposed 2018 rule, in case you have a need to reference them directly.

5The Healthmonix Advisor

If you still have questions about MIPS, try searching or subscribing to Healthmonix’ extensive collection of weekly blog posts. Healthmonix addresses a vast range of topics; from the 2018 proposed rule, to the absolute minimum required for MIPS success.

If you take just a few hours to explore these free resources, you can equip yourself with the knowledge you need to report successfully. But hurry--time is running out!