#What is MACRA?
#MIPS vs Advanced APMs
#Who can Participate?
#MIPS Performance Categories
#Clinical Quality Measure Webinar PPTs
IMPORTANT: Elation has created a cheat sheet that will help you with meeting the criteria for the different Clinical Quality Measures (CQMs). We encourage you to check the attachments section for more information.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare Sustainable Growth Rate and replaces it with a new program known as the Quality Payment Program (QPP).
Beginning on January 1st, 2017, qualified providers will participate in one of two tracks, either Advanced Alternative Payment Models (Advanced APMs) or the Merit-based Incentive Payment Program (MIPS).
- Practice is excluded if provider or provider's group has ≤$90,000 in Part B allowed charges or ≤200 Part B beneficiaries.
- QPP Participation Tool to identify eligibility (NPI needed to search)
MIPS Performance Categories
There continues to be four performance categories in 2018; Clinical Quality Measures, Cost, Improvement Activities and Advancing Care Information. The weighted score (in %) from each category will be added together to give you a final MIPS score. The final MIPS score is compared to the MIPS performance threshold to determine if you receive a partial, neutral or negative payment adjustment in 2020.
- Full participation in the Improvement Activities category, such as submitting one high-weighted activity or two medium-weighted activities for small practices, or two high-weighted activities, four medium-weighted activities, or a combination of both medium- and high-weighted activities;
- The Advancing Care Information (ACI) category base score and one quality measure meeting the measure threshold, or data completeness, but not benchmarks
- ACI base score and one medium-weighted improvement activity
- Six quality measures meeting data completeness, but not measure benchmarks
- If providers report a particular measure, but do not meet the benchmarks or submission thresholds, they will automatically receive a score of 3 points for that measure if they are in a small practice, and 1 point if they are in a larger practice.
Clinical Quality Measure Webinar PPTs
Session 1: Diabetes Related Measures
Session 2: Cancer, Cognitive, Falls Related Measures
Session 3: Hypertension and BMI Related Measures
Session 4: Immunization Related Measures
Session 5: FAQs and Troubleshooting Tips