MACRA & MIPS

MACRA & MIPS

MediFusion Helps Practices Stay Up-To-Date on MIPS Quality Payment Programs (QPP)

macra and mips

What is MACRA?

2015’s Medicare Access and CHIP Reauthorization Act or MACRA is a legislation act made to overlook Medicare payment system for healthcare providers. Quality Payment Program (QPP) by Medicare is based on MACRA guidelines for reimbursements and presents Clinicians with two tracks for reporting which are:

MACRA & MIPS
Merit-based Incentive Payment System

Merit-Based Incentive Payment System (MIPS) is designed for value-based reimbursement.

Alternative Payment
Model

Advanced Alternative Payment Methods (APMs) provide added incentive payments to offer cost-efficient and high-quality care. MIPS eligible physicians who are also APM participants are subject to MIPS.

Merit-based Incentive Payment System

Merit-Based Incentive Payment System (MIPS) is designed for value-based reimbursement.

Alternative Payment Model

Advanced Alternative Payment Methods (APMs) provide added incentive payments to offer cost-efficient and high-quality care. MIPS eligible physicians who are also APM participants are subject to MIPS.

Eligibility Criteria

  • Surpass the low-volume limit as an individual or a group.
  • Enrolled in the Medicare before 2020.
  • Do not become a Qualified Participant (QP) or even a Partial QP.
  • An APM individual with QP status that wishes to participate in MIPS.
  • Are part of an APM Entity MIPS APM entity that exceeds the low-volume threshold.

Find out more about how to determine your eligibility

All eligible healthcare professionals must participate in MIPS. Check your participation status

MACRA & MIPS requirements

Get High MIPS Scores to Earn More

MIPS allows physicians to receive a better performance-based payment adjustment on reimbursements based on their reporting score. So let MediFusion help earn you more as you document and keep track of your performance towards achieving your MIPS objectives.

MACRA & MIPS

Quality (45%)
Replacing PQRS, this category focuses on the quality of care you deliver, based on CMS performance measures as well as stakeholders and other medical professionals. You can pick six measures of performance that best suit your practice.
Promoting Interoperability (25%)
This category covers patient engagement as well as the use of Certified Electronic Health Record Technology (CEHRT) during exchange of information. This is done by actively sharing information in a comprehensive manner with patients and other clinicians. These include sharing visit summaries, therapeutic plans and test results with patients and other facilities.
Improvement Activities (15%)
A relatively new category, this is used to measure your participation in improvement of your practice. This includes activities that can improve your patient engagement, increase access to care. You are allowed to choose activities that better suit your practice such as patient and clinical shared decision-making, expansion of practice access and enhancing care coordination.
Cost Measures (15%)
This category replaces VBM. The cost of the care you provide to patients based on your Medicare claims is calculated by CMS. MIPS measures the total cost care throughout the year or during a patient’s hospital stay.

Automated MIPS Reporting & Tracking System

Our MIPS support system is designed for healthcare professionals to keep them on track with gaining more in positive payment adjustments and avoid penalties. Contact us for more details

MIPS

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