Almost a full year has passed since the Centers for Medicare & Medicaid Services (CMS) deemed 2017 as the transitional year for independent physicians to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA has two available tracks: Alternative Payment Models (APMs) and a Merit-Based Incentive Payment System (MIPS). At this point, most physicians should at the very least, be aware of MIPS, but for those still unfamiliar: MIPS replaces the previous years’ Medicare reimbursement system and existing value-based care programs (physician quality reporting system or PQRS, meaningful use and the value-based modifier) with a new pay-for-performance program. While we can expect to see ongoing shifts in the legislation, the new program is focused on quality, value and accountability and emphasizes quality of care over number of patients seen. Regardless of MIPS’s original intent to improve health care for both patients and physicians, the new legislation can result in negative Medicare payment adjustments if not followed correctly.
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