Physician Fee Schedule (PFS)/MACRA/QPP
A performance threshold. Clinicians who score above the performance threshold will receive positive payment adjustments on a sliding scale, and clinicians who score below the threshold will receive negative payment adjustments on a sliding scale. CMS will publish the performance threshold prior…
However, the QPP’s payment implications will vary depending on a number of scenarios – such as whether a clinician is attributed to the Merit-Based Incentive Payment System (MIPS)i; to a MIPS alternative payment model (APM); or to an advanced APM. See Figure 1. While MIPS-eligible clinicians have a…
Specifically, CMS has designated certain Medicare APMs as “MIPS APMs.” In 2017, these include Tracks 1, 2 and 3 of the MSSP and the Next Generation Accountable Care Organization (ACO) program. A full list of APMs that qualify as MIPS APMs is available on CMS’s website. Clinicians who participate in…
APM entities and clinicians will know their QP or partial QP status before the MIPS election period; CMS anticipates announcing 2017 determinations before Dec. 31, 2017. APM entities or clinicians that are determined to have partial QP status may elect to participate in MIPS. As a default, CMS will…
Method I Critical Access Hospitals (CAHs)
Under Method I, the CAH bills Medicare for facility services and clinicians’ professional services separately under the physician fee schedule (PFS). In this case, The Centers for Medicare & Medicaid Services (CMS) will not make MIPS adjustments to a…
Individual clinicians and group practices participating in the Quality Payment Program can submit their 2017 performance data through March 31 at https://qpp.cms.gov/login, eliminating the need to submit the data on multiple websites, the Centers for Medicare & Medicaid Services announced…
Individual clinicians and group practices participating in the Quality Payment Program can submit their 2017 performance data through March 31 at https://qpp.cms.gov/login, eliminating the need to submit the data on multiple websites, the Centers for Medicare & Medicaid Services announced…
The AHA has collected links to additional MACRA resources that you may find helpful.
The AHA today released a suite of resources to help post-acute care providers prepare for Medicare’s new payment program for clinicians under the Medicare Access and CHIP Reauthorization Act. From an on-demand webinar outlining the most salient issues for PAC providers to a quality measure…
MACRA Resources for Post-acute Care Providers