MGMA16: 6 steps to prepare your practice for MIPS

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SAN FRANCISCO--When it comes to the new Medicare payment system for physicians, the Merit-based Incentive Payment System will be the road more traveled.

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About 45 percent of clinicians who will be paid under the Centers for Medicare & Medicaid Services' reimbursement system that implements the Medicare Access and CHIP Reauthorization Act will be covered by the MIPS payment track, said Jennifer McLaughlin, J.D., senior associate director for government affairs at the Medical Group Management Association.

She spoke at a packed session at the association’s annual conference in San Francisco, the first of several presentations to get members ready for MACRA. Perhaps the standing-room only session was further indication that physicians do not know much about MACRA and are looking for information.

“We are charged with solving a 2,400-page riddle,” said McLaughlin, holding up the phone book-sized final rule that outlines the implementation of MACRA.


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So what can physician practices do now to get ready for the new payment system under which clinicians must start reporting performance measures in 2017 for the first payment year in 2019? Suzanne Falk, MGMA’s associate director of government affairs, recommended six steps:

  • Assess your practice’s performance under current quality programs, such as Meaningful Use and the Physician Quality Reporting System. The good news is that practices that are successful under current programs will probably be successful under MACRA, said Mollie Gelburd, J.D., also an associate director at MGMA. Download your Quality and Resource Use Reports and PQRS feedback report that provide information on payment adjustments and improvement opportunities. Don’t forget to submit any informal review requests to correct report errors by November 30.
  • Decide which MACRA pathway is best suited for your practice. Along with MIPS, practices can opt for advanced Alternative Payment Models (APM).
  • Evaluate your electronic health record and other vendors in terms of their readiness and costs.
  • Decide if your practice will report MIPS at the individual or group level and select a reporting mechanism.
  • Explore applicable measures and improvement activities. This is the first time practices will need to report improvement activities, but the good news is they are actions that a lot of physicians are already doing, such as providing patients with 24-7 access to clinicians for urgent care needs
  • Learn as much as you can about MACRA and MIPS. The MGMA offers updates and resources, including a new egroup for information about MIPS and APMs.