MACRA (Medicare Access & CHIP Reauthorization Act)

MACRA
(Medicare Access & CHIP Reauthorization Act)

In October, The Centers for Medicare & Medicaid Services (CMS) released the final rule for MACRA, altering how Medicare reimburses clinicians and their practices. It emphasizes quality, value, and clinicians taking more financial risk.

TSI Healthcare® is here to help you navigate through the murky waters of federal regulations.

Be sure to check out our other resources:

MACRA Webinar MACRA Blog Series MACRA 101 Quiz

What’s The Big Idea?

With a stronger emphasis on quality, value, and bigger financial risk, there are three key areas MACRA seeks to address.

MACRA SGR

Repeals SGR

Sustainable Growth Rate

MACRA HR Icon

Shifts from Volume to Quality

Shift from fee-for-service
to pay-for-quality

MACRA Man

Extends CHIP

Children’s Health
Insurance Program

Quality Payment Program

MACRA’s Quality Payment Program will allow providers to select between two quality payment program.

Download MACRA Infographic

MIPS

APMs

Merit-Based Incentive Payment System

  • Combines Meaningful Use, PQRS/CQMs & VBM
  • Measures Providers On:
    • Quality
    • Advancing Care Information (Use of EHR)
    • NEW Improvement Activities
    • Cost (coming in 2018)
  • Financial Implications
    • Can Receive Negative or Positive Payment Adjustments Based On MIPS Score
    • Can Earn Up to 22% Bonus (for exceptional performers) Or 4% Max Penalty

Advanced Alternative Payment Models

  • Must Require Certified EHR Use
  • Must Base Payment On Quality Measures Comparable To MIPS Quality Category
  • Must Bear Financial Risk
  • Financial Implications:
    • Must Bear Financial Risk
    • Can Earn 5% Bonus

Timeline

MIPS will begin in 2017 as its first performance year with payment adjustments beginning in 2019.

MIPS Program Overview

MIPS combines MU, PQRS, and VBM to measure clinicians in four different categories.
The new quality program structure increases emphasis on PQRS while decreasing it on Meaningful Use.

MACRA Pie Chart

MACRA A+

Quality = 2017 – 60%,
2018 – 50%

Learn More

MACRA Screen

Advancing Care
Information = 25%

Learn More

MACRA Clipboard

Improvement
Activities = 15%

Learn More

 

MACRA Money SIgn

Cost = 2017 – 0%,
2018 – 10%

Learn More

More Exciting News

MACRA proposes more exciting reporting and data submission options.

Group Reporting

M

Increased Flexibility With Pick Your Pace

M

No Longer All or Nothing

M

Introducing Quality Program Services

Overwhelmed by MACRA and MIPS? Stress no more!
TSI Healthcare’s revolutionary new approach to federal policy assistance provides you with the next level of
regulatory assistance and client advocacy.

Bi-annual QRUR Reviews

Bi-annual QRUR reviews designed to provide you with an analysis of Medicare costs attributed to your practice.

Workflow Workshops

Workflow “how-to” videos for easy learning on the fly for role-specific and specialty-specific measures.

Guided Assistance

Guided assistance with hands-on regulatory training from a Quality Program Specialist allows you to focus on patient care.

  • "The support has been the biggest area that has helped because we don’t have enough time to read through all the government regulations. The added benefit of having TSI Healthcare made it easier to know we were on the right track, and they had our back."

    Jeanette DayArthritis and Rheumatic Diseases
  • "We truly have a partnership with TSI Healthcare. For me, the greatest assets have been the implementation team that helped us bring the whole process into the office. The Meaningful Use team has really helped us navigate through all of the regulatory requirements to receive our bonuses and to make sure that we are using our EHR the way it was designed to be used."

    Robert Stutman, OD, MBA, FAAOSelect Eye Care
  • "One of the things that we couldn't live without is the Meaningful Use team. They have held our hands from the beginning, and we could definitely not live without them. Also, the support team and access to their help. From the beginning, this was something we found so important to us."

    Lynne MarletteThe Hirsh Center
  • "The biggest challenge that we faced before starting with TSI Healthcare was meeting Meaningful Use. I was a bit concerned about our practice because we had missed one year of Meaningful Use money already. It was one of the driving factors for selecting them as a vendor, and they have helped us achieve that."

    Robert Collins, Director of OperationsBoston Laser Eye Institute, P.C.

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