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:

Informational Webinars MACRA Blog Series Download MACRA Infographic

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.

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.

timeline_final_rule2016_rev1-11

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

Webinar: MACRA 101 

With multiple new additions for reporting categories and options to participate in either MIPS or Advanced APMs, practices are encouraged to watch this webinar to learn more about the new payment structure.

  • "We have had to do almost nothing for Meaningful Use, it just happens. So, it's been a piece of cake for me."

    John C. Huntwork, MDJohn Huntwork, MD
  • "One of the main challenges that any practice has had in the last 3 or 4 years is being ready for Meaningful Use 1 and now Meaningful Use 2. TSI Healthcare is very knowledgeable and well versed. They have an excellent staff that can help with the regulations and changes that are needed. They are there to support you. We wouldn't be where we are today without TSI Healthcare's help."

    Jason Rubinstein, Practice AdministratorCentral Florida Retina
  • "I just want to tell you how much I greatly appreciate the continued support from the TSI Healthcare team. All that is being required by CMS is a huge undertaking, and I know we could not accomplish these tasks without the assistance from your company. Thank you."

    Donna Baker, Office ManagerAtlantic Pulmonary Associates
  • "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

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