CHANGES IN MEDICARE REIMBURSEMENT Hello MACRA Medicare's new Quality Payment Program (QPP) is a product of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). QPP is 1 component of the reinvention of how Medicare will pay its Part B providers following the end of the Sustainable Growth Rate formula methodology: OR MIPS APMs (Merit-based Incentive Payment (Advanced Alternate Payment System) Models) Possible performance-based payment Possible Medicare incentive payment adjustment through MIPS for participating in an innovative model WHO IS ELIGIBLE? A provider who bills Medicare Part B >$ for care to > 100 30 k/ yr. Medicare patients/ yr. as a: Physician Physician Assistant Nurse Practitioner Clinical Nurse Specialist Certified Registered Nurse Anesthetist WHEN? Data collecting can start as early as January 2 2017 , 1 2017 , or as late as October . MIPS has a 90 -day minimum reporting period requirement All calendar year 2017 data must be submitted to Medicare by March 2018 31 , For more information or help in navigating these new changes, contact Katie Graham at 865 862 3020 - kgraham@lbmc.com - or CHANGES IN MEDICARE REIMBURSEMENT Hello MACRA 2019 Medicare payments will be adjusted based on CY 2017 MIPS reporting performance : Not participating in MIPS? Do not report any 4 - 2017 data and receive a % payment adjustment Don't participate Want to remain neutral? Avoid downward payment by submitting a minimum amount of 2017 data to Medicare Submit Something Want to potentially increase payments? Earn a neutral or small + payment by submitting 90 days of 2017 data Submit a partial year Want to earn the maximum incentive? Earn + payment by submitting a full year of 2017 data Submit a Full Year How to participate : The 4 Categories of MIPS Quality CPIA Replaces Physician Quality Reporting System (PQRS) 80 90 - Clinical Practice Improvement Activities New Category 40 points ACI COST Advancing Care Information Replaces Meaningful Use (MU) Cost and Resource (RU) Replaces Value­based Modifier (VBM) 100 points 100 points points Average score of all attributable RU measures 60% Fulfill the Report up to 6 of 271 total quality measures, including an outcome measure for a minimum of 90 4 of 93 1 90 of 90 days: 2 . e-Prescribing activities for a minimum of required ACI . Security Risk Analysis total improvement days 5 measures for a minimum Attest that you completed up to 0% for 2017 25% 15% 3 4 . Provide Patient Access days . Send Summary of Care 5 . Request/ Accept Summary of Care Additional bonus dollars available for those that score above For more information or help in navigating these new changes, contact Katie Graham at 865 862 3020 - - kgraham@lbmc.com or 70 No reporting requirement for CY 2017 Calculated from adjudicated claims