MACRA

Medicare Access and CHIP Reauthorization

LEARN ABOUT MACRA

Medicare Access and CHIP Reauthorization Act of 2015img1
Components:
- Merit-based Incentive Payment System (MIPs) impacts
~700,000 physicians
- Alternative Payment Models (APMs) impacts ~70,000
physicians that are already in ACOs, MSSPs, and CMMIs etc.
Impacts any Physician who does Part B billing
WHAT IS MIPS?
Consolidates three existing quality reporting programs, plus adds a new program, into a single system which consists of the following categories:

img2

WHY SHOULD I CARE?
Based on your CPS for 2017, beginning in 2019 physicians participatingimg3in MIPS will be eligible for positive or negative Medicare payment adjustments that start at 4 percent and gradually increase to 9 percent by 2022. The threshold for these payment adjustments will be the mean or median CPS for all MIPS-eligible professionals during the previous performance period.
The program is required to be budget neutral, which means:
No payment adjustment: Physicians who score at the mean.
Positive payment adjustment: Physicians who’s CPS is above the mean.
Negative payment adjustment: Physicians who’s CPS is below the mean.
Physicians with higher composite scores will be eligible for an additional positive payment adjustment up to three times the baseline positive payment adjustment for a given year.

PERSIVIA PLATFORM FOR MIPS
Persivia brings years of expertise in helping 100s of hospitals and 1000s of providers to improve their quality metrics and decrease associated costs. Leveraging the state of the art Persivia Clinical Decision Support system populated by more than 30,000 evidence based rules, the Persivia platform helps providers stay ahead and score high!
Integrated Platform to monitor performance across all MIPS Categories
Composite Performance Score with breakdown of performance in individual MIPS Categories
Interactive dashboards with drill down capabilities for performance review
Real time Clinical Decision Support helping achieve higher performance on CQMs, Clinical Performance
Indicators (CPI) and evidence based guidelines to decrease unnecessary services to improve efficiency and
Resource Use (RU).
Extraction of data out of your Electronic Health Record System and Billing/Claims systems
Production of Electronic files for submission
PARTICIPANTS
MIPS applies to, Medicare Part B clinicians, including physicians, physician assistants, nurse practitioners,
clinical nurse specialist, and certified registered nurse anesthetists. All Medicare Part B clinicians will report
through MIPS during the first performance year, which begins January 2017. Medicare Part B clinicians may be exempted from the payment adjustment under MIPS if they:

img4

img5