(Medicare Access & CHIP Reauthorization Act)
In November 2015, 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:Download our MIPS 2021 Guide
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.
Sustainable Growth Rate
Shifts from Volume to Quality
Shift from fee-for-service
Congratulations to TSI Healthcare Small Practices!
In 2019, 100% of clients using our Quality Program Services received the exceptional performer bonus.
MIPS penalties/incentives are calculated based on a 2-year look-back period
- Combines Meaningful Use, PQRS/CQMs & Value-Based Modifier (VBM)
- Measures providers on:
- Promoting Interoperability (Formerly ACI)(Use of EHR)
- Improvement Activities
- Financial Implications
- Can receive a negative or positive payment adjustment based on MIPS Composite Score
- Can receive up to 9% max penalty for not meeting 2021 MIPS requirements
- Measures providers on:
- APM specific goals, similar to MIPS with a few additions & exceptions
- Financial Implications:
- APMs can receive incentive payments for providing high-quality & cost-efficient care
- Advanced APMs bear financial risk & can earn a 5% bonus
MIPS will continue in 2021 as the 5th performance year. Payment adjustments received in 2021 are based on 2019 performance.
MIPS Year 5 Program Overview
The new quality program structure increases emphasis on interoperability and quality, while decreasing patient costs.
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.
"TSI Healthcare is top-notch when it comes to federal policy guidance. They help us with attestation and they explain the government regulations."Hope, System Support & Implementation MangerTidewater Physicians Multispecialty Group, P.C.
"As government regulations continue to evolve, TSI Healthcare remains current regarding the changes and always keeps us informed in a prompt manner."Ana, Director of Clinical PracticeArthritis & Rheumatism Associates, M.D.
"TSI Healthcare’s rheumatology specific EHR is very manageable to use, and their reporting system is very flexible. We are on track for meaningful use, and it has allowed us to enjoy a significant increase in revenue. This has let us add to staff and incorporate an ultrasound machine.”Kevin Hicks, MDCollaborative Arthritis Care, Inc.
“There are a lot of changes coming with the new MIPS and MACRA programs for Medicare, and there is no way I could possibly stay on top of it and run a medical practice. We rely very heavily on the Government Regulations team at TSI Healthcare. Our practice greatly benefits from their knowledge about MACRA. They stay on top of the changes and help us navigate them.”Connie, Director of Business OperationsCape Fear Arthritis Care