To help Medicare providers transition into the new payment methodologies included under MACRA, CMS has designated 2017 as a “transition year” for the Quality Payment Program, which means there are three MIPS participation options for eligible clinicians with varying requirements as it relates to reporting data to CMS.
|MIPS Test Pace||MIPS Partial Year||MIPS Full Year|
|Submit a minimum amount of data after January 1, 2017 and avoid a negative payment adjustment in 2019.||Report data to CMS for a 90-day performance period that begins after January 1, 2017. Avoid a negative payment adjustment and be eligible to earn a small positive payment adjustment.||Fully participate in MIPS starting January 1, 2017 and report data to CMS for the full performance period (Jan 1, 2017 through Dec 31, 2017). Avoid a negative payment adjustment and be eligible to earn a modest positive payment adjustment|
Providers who successfully participate in the partial or full-year option will be eligible to receive a positive payment adjustment on Medicare reimbursements starting in 2019, and providers who participate for a full year will also be eligible to receive additional bonus incentives if they meet exceptional performance requirements.
To meet Test Pace requirements using Practice Fusion, a provider must report the following data:
- 1 quality measure, OR
- 1 improvement activity, OR
- The 4 base measures included in the Advancing Care Information Transition Measure set.
Some eligible clinicians may be in practices that choose to participate in an Advanced Alternative Payment Model in 2017, although it is important to note that eligible clinicians participating in an Advanced APM to do not automatically avoid the MIPS payment adjustment.
Source : Center for Medicare and Medicaid Services. Transitioning from PQRS to MIPS webinar slides. January 2017.
What is the Quality Payment Program?
Quality Payment Program is the name given to the new Medicare value-based reimbursement system. The program has two tracks for participation: MIPS and APM
What are APMs?
MACRA allows providers who take further steps towards transforming healthcare to be exempt from MIPS and participate in Advanced Alternative Payment Models (APMs).
How to prepare
Individual eligible providers can prepare to meet all MIPS measures and be ready to avoid penalties and earn bonuses on January 1, 2017.