CHANGES TO PHYSICIAN MEDICARE REIMBURSEMENT LAW

The CMS final rule regarding The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), now being called the Quality Payment Program (QPP), was issued in October and has taken effect. Although your reimbursement will not be affected until 2019, new reporting processes are underway as of January 1, 2017. USPI’s Physician Strategy Group is here to help you demystify the changes and understand how the ruling impacts your practice.

ABOUT QPP

WHAT DOES IT DO?

The rule establishes new Medicare payment options for physician services furnished under Medicare Part B. The Quality Payment Program (QPP) ends the sustainable growth rate and the potential for double-digit rate cuts.

WHAT’S NEXT?

The new payment methodology gives providers two participation options: The Merit-based Incentive Payment System (MIPS), expected to be the primary payment track in the QPP, and the Advanced Alternative Payment Models (APMs).  While this new methodology applies to payments beginning in 2019, reporting for the first year of the QPP begins in January, 2017.

WHAT DOES IT MEAN?

PQRS, Value-based payment modifier (VM), and the EHR Incentive Program (Meaningful Use) – will go away at the end of 2016 along with the penalties incurred (they phase out in 2018). These programs will be consolidated with a new component added – Clinical Practice Improvement Activities.  Good news is that positive payment adjustments are possible with minimal participation in 2017, as little as submitting a single measure or activity.

WHAT DO I NEED TO DO?

You should familiarize yourself with the new payment structures and determine which participation option is right for your practice. You will also need to understand and implement the new reporting structure because it will affect your reimbursements beginning in 2019.

USPI’s Physician Strategy Group will provide resources and guidelines to help you understand how the rule applies to your practice and keep you abreast of timelines for participation.  Get started today by viewing the links on the right, or contact us directly at (855) 207-5203 or info@uspi-psg.com.

 

 

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Rick Weymier –

The Carrel Clinic