MACRA Made Easy

We hold your hand every step of the way

What is MACRA?

MACRA is the latest legislation from CMS regarding physician reimbursements. It defines the “QPP” (quality payment program) under which you’ll be paid “for quality”. The program has 2 subsets; MIPS (Merit Based Incentive Payment System), and, APM (alternative payment model) . CMS expects 95% of providers to go with MIPS. What does MIPS mean for you?

Under MIPS, you’ll be ranked based on

  • Quality (60%)
  • Advancing care information (25%)
  • Clinical Practice Improvement Activities (15%)
  • Resource use (starting in 2018)

What it Means for You

You might think “this doesn’t sound simple!” Well, here’s a translation of the government terms, and, a few words on how to meet them without too much trouble.

  • Quality – this is exactly the PQRS program you’ve been part of for years, under a different name. And AMOS has everything you need to handle it built right in. We’ll tell you when a patient should be considered for a quality measure, and what to document. Once you’re done, we’ll automatically calculate your numbers and submit your data to CMS. And, AMOS will automatically search for data that’s already there, like diagnoses, labs, or meds, so that you have to check only the minimal number of boxes.
  • Advancing care information – again, existing program, different name. This is just the next iteration of the meaningful use program you’re already used to. And you’ll be doing fewer measures than ever. Once again, AMOS will make it easy; our ACI/MU dashboard will tell you exactly what measures you need to meet, and how you’re doing with them.
  • Clinical practice improvement activities (CPIA) – a whole menu of optional measures you can do to get credit for this one. But did you know, that some of these measures are nothing more than a few broadly based quality measures? So, just do exactly what you’re already doing for the “Quality” section, add a few more quality measures, we’ll submit them for you, and, you’re all set. If you want to do different measures which aren’t quality measures per se, AMOS supports that too.
  • Resource utilization: As a small provider, this one is mostly out of your hands. CMS will look at overall spending on your patients, and rank you based on this. Basically, as always, you want to limit hospital admissions and readmissions as much as possible. So, you don’t really have to do anything with regard to this measure.

After you’ve submitted all the necessary data for each of these requirements, CMS will rank you against everyone else, and, depending on your performance, you might get an incentive payment.

Did you know that in 2017, if you want, you can do nothing more than submit ONE quality measure (ASP.MD can do this for you in a matter of minutes), and call it a day? You won’t get any incentive payment, but; you’ll fully avoid the otherwise 4% penalty. No meaningful use, 1 quality measure, no CPIA. One and done.

What is APM?

And that’s it! 2,400 pages of legislation boils down to what’s above. But- what about APM? An APM is the other option you can pursue, in which you become part of a provider group caring for patients, and the groups reimbursements are put at risk as whole. Do you really want to get involved in a situation in which your reimbursements are based on other providers performance, which you can’t control? Probably not. You’ll be required to do pretty much the same things with your EHR in either program, but, even if you perform terrifically, you could be penalized for the poor performance of others.

Now that the new legislation is out, numerous interested parties are all out there telling  you it’s all much too complex for you to even understand, and that you simply have to become an employed provider of a large institution. From our perspective, these are scare tactics, aimed at taking advantage of you.

ASP.MD, at least, believes that what you need to do *isn’t* that hard, that our system makes it easy, and that we can show you what to do.


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