Post on 15-Apr-2017
THREE MAJOR CHANGESEnding the Sustainable Growth Rate (SGR) formula for determining Medicare payments for health care providers’ services.
Making a new framework for rewarding health care providers for giving better care not just more care.
Combining the existing quality reporting programs into one new system.
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TWO TRACKS FOR PHYSICIANS TO CHOOSE FOR REPORTING
MIPSMerit-based Incentive System APMs
AlternativePaymentModels
MIPS is a new program which combines the Physician Quality Reporting System, Value Modifier and Meaningful Use programs into one program.
MU PQRS VM MIPS
MIPS
Physicians receive a composite score based on their performance in these 4 areas:
MIPS
= MIPS Composite Performance Score
Quality Resource
Use
Clinical Practice
Improvement Activities
Meaningful EHRUse
+ + +
Your Composite Performance
Score will determine if you
receive a negative
adjustment, no adjustment or a
positive adjustment to your funding.
APMs
APMs provide a new way for Medicare to compensate healthcare providers.
Most providers who participate in APMs will also be subject to MIPS.
Advanced APMs are not subject to MIPS.
Advanced APMs include:
• Accountable Care Organizations (ACOs)
• Patient Centered Medical Homes
• Bundled Payment Models
Very few health systems will fall into this category at first.
AdvancedAPMs
Almost everyone reports under MIPS in 2017
Whether you are taking the MIPS or APM track the majority will report for MIPS.
Exclusions:• New to Medicare• Very low Medicare billing volume• Qualified for advanced APM status
Option 1
Submit some data to the Quality Payment Program, including data from after January 1, 2017.“ “
Yup…it’s that vague. (Look for more information when the final rule is released.)
Option 2
Submit MIPS information for a reduced number of days.
• You can start later than January 1, 2017• Select from the list of quality measures and
improvement activities in MIPS
Option 3
Submit MIPS information for a full calendar year.
• First performance period begins January 1, 2017
Option 4
If you receive enough of your Medicare payments or see enough of your Medicare patients through the Advanced Alternative
Payment Model in 2017, then you can
report with this option.
To learn more about Medisolv’s Quality Reporting software that
supports your needs visit Medisolv.com
www.medisolv.com | (844) 633-4675 | info@medisolv.com