What is MACRA and where does MIPS fit in?
MACRA, or the Medicare Access and CHIP Reauthorization Act of 2015, created the Quality Payment Program. Most providers will follow the MIPS track of the Quality Payment Program. The other option is to participate in the Alternate Payment Model, or APM. Please consult Medicare to make the correct choice between MIPS and APM for your practice. See below for assistance with MIPS.
By providing high quality, efficient care supported by technology, providers participating in MIPS may earn a positive payment adjustment to their Medicare reimbursement. MIPS centralizes the various EHR reporting initiatives required by Medicare. The combination of Meaningful Use, PQRS, and Value-Based Modifiers with new Improvement Activities creates the 4 MIPS categories to which providers must attest:
- Quality (Replaces PQRS)
- Improvement Activities (New Category)
- Advancing Care Information (Replaces Meaningful Use Reporting*)
- Cost (Replaces the Value- Based Modifier)
Providers can participate as individuals or as part of a group. To determine your participation options please consult CMS.
Image via qpp.cms.gov/mips/overview
Ways to Participate in MIPS
Per CMS there are 3 ways to participate in MIPS 2018. For details, please visit the official CMS site.
- Participate as an Individual- MIPS eligible clinicians participating as individuals, will have their payment adjustment based on their individual performance.
- Participate as a Group - MIPS eligible clinicians participating in MIPS with a group will receive a payment adjustment based on the group's performance.
- Participate as a Virtual Group - MIPS eligible clinicians participating in MIPS with a Virtual Group will receive a payment adjustment based on the Virtual Group's performance.
How can Aprima help?
Aprima is ready and equipped to help you succeed with the Merit-Based Incentive Program, or MIPS. Aprima is pleased to offer a MIPS Assistance Program for our customers. This is an optional service for those who feel uncomfortable navigating the process alone, or for those who want an extra level of oversight as they move into a more complicated and sometimes challenging stage of quality reporting.
This program is designed to assist you in understanding all of the requirements, choosing the measures that will yield the best data, and configuring your database to accurately and efficiently capture all of the necessary data. We will also assist you in submitting your data to CMS, when the time comes. It is important to note that practices must be diligent in the capture of clinical information. Also note, it is the sole responsibility of the practice to manage the Improvement Activity component of MIPS. This function can’t be outsourced.
- 1-on-1 initial consultation session with your office to determine the measures that you wish to report on
- System configuration
- MIPS Workflow consultation
- Recurring 1-on-1 meetings to review your current status
- Assistance submitting your data to CMS
*Certified Software is still required.
APRIMA DOES NOT GUARANTEE A PROVIDER OR PRACTICE WILL EARN OR AVOID ANY PENALTIES OR PAYMENT ADJUSTMENTS ASSOCIATED WITH DATA THAT IS REPORTED OR SUBMITTED. APRIMA WILL NOT INDEMNIFY ANY PROVIDER OR PRACTICE IN THE EVENT OF AUDIT FAILURE OR OTHER GOVERNMENTAL ACTIONS ASSOCIATED WITH ATTESTATION.