Editor’s note: MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015, and is Medicare payment reform that goes into effect Jan. 1, 2017. The associated Quality Payment Program (QPP) is the regulation that will shift the reimbursement model from straight fee for service to a more comprehensive value-based framework. In this MACRA 101 blog series, Jim Brulé dives into the details of the two tracks within the QPP, the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs). The Centers for Medicaid and Medicare (CMS) estimates that of the 712,000 Medicare Eligible Clinicians (ECs) that will participate in the QPP, about 87% will default to the MIPS track in the initial years. It has lower risk but also lower incentives, as it was crafted by Congress to ultimately be the less attractive option. Calculating […]

MACRA, which stands for the Medicare Access and CHIP Reauthorization Act of 2015, was legislation that reformed the Medicare payment system to help lower the cost of health care, while delivering better quality and improving health outcomes. It represents a huge change – it creates a more comprehensive value-based framework for payment and combines different quality-based measures into one system. In October, the Center for Medicare and Medicaid Services (CMS) issued the final rule for the new Quality Payment Program (QPP) following direction from the MACRA, and it goes into effect Jan. 1, 2017. As we get closer to this regulatory program, here are some key points to consider: While 2017 is a transition year, Medicare Eligible Clinicians (ECs) must take action to avoid a penalty. CMS anticipates that more than 700,000 Medicare ECs will participate in the QPP. ECs […]

Following every election cycle, the United States experiences a change in policy and direction. During his campaign, Donald Trump said little about his plans for health IT, precision medicine or delivery system reform, so it will take some time for us to have a real sense of his administration’s thoughts on these subjects. Since his election, I’ve already had many conversations with healthcare policy experts. Insights from these discussions include: 1) Interoperability – Continues to be a priority Congress remains interested in monitoring success with healthcare interoperability and the possibility of legislative action, including attention to further standards development.  Congress will also be paying close attention to the implementation of the MACRA, gauging whether it is successfully driving the adjusted behavior from clinicians that they are seeking. 2) MACRA – Adjustments may take place, but the core program will remain consistent […]

Editor’s Note 12/2/2016: In October, the Center for Medicare & Medicaid Services (CMS) issued MACRA’s QPP Program’s final rule, which goes into effect Jan. 1, 2017. Allscripts is committed to helping healthcare organizations stay ahead of these upcoming requirements. Read more here: MACRA 101: We have the final rule for the QPP…now what? Last week The Centers for Medicare and Medicaid (CMS) Acting Administrator Andy Slavitt issued an official blog post announcing proposed reporting options for the Quality Payment Program (QPP), the program stemming from the Medicare Access and CHIP Reauthorization Act (MACRA), for program year 2017. The intent of these options is to give participants more flexibility during the initial year of this significant program. For 2017, the blog post identifies four options: 1) Submit “test” data to CMS for any period of time within 2017. Choosing this option will […]

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A beginner’s guide to MACRA

Editor’s Note 10/31/2016 – Earlier this month, the Center for Medicare and Medicaid Services (CMS) issued MACRA’s QPP Program’s final rule, which goes into effect Jan. 1, 2017. Allscripts is committed to helping healthcare organizations stay ahead of these upcoming requirements. Join a webinar overview on MACRA QPP, updates from the final rule and what organizations should be doing now to prepare. Hospitals and health systems can click here to register, physician practices can click here to register. Read more here: MACRA 101: We have the final rule for the QPP…now what? MACRA is perhaps the most significant piece of proposed healthcare regulation I’ve ever seen. We’ve had a series of webinars to help clients understand the key points, and distilled them here in a Q&A format. What is MACRA? MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. […]

Editor’s Note 12/2/2016: In October, the Center for Medicare & Medicaid Services (CMS) issued MACRA’s QPP Program’s final rule, which goes into effect Jan. 1, 2017. Allscripts is committed to helping healthcare organizations stay ahead of these upcoming requirements. Read more here: MACRA 101: We have the final rule for the QPP…now what? The Medicare Access and CHiP Reauthorization Act (MACRA) was signed into law by President Obama in April 2015 with overwhelming bi-partisan support. The bill includes many changes, and arguably the most critical impact is the introduction of a new payment model that will affect all providers starting with the 2019 payment year. Unfortunately, many in the healthcare industry have a false sense of security: while 2019 is the official start date for the new payment models, 2017 will be the performance year that determines 2019 payment adjustments. Be […]

The Health Care Payment and Learning Action Network (HCPLAN) recently held its first summit in Washington, D.C.  I joined about 250 healthcare industry leaders at this event, which demonstrated that this group will play a significant role in shaping health care’s transition from fee-for-service to value-based-care models. The U.S. Department of Health and Human Services (HHS) created the HCPLAN earlier this year towards the goal of moving 30% of Medicare reimbursements to alternative payment models in 2016 and 50% by 2018. Through the HCPLAN, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs. Two of the main topics at the summit were the Alternative Payment Model (APM) Framework and Medicare Access and Chip Re-authorization Act (MACRA). Here’s a summary of key points in each […]