MACRA | MDLand

What is MACRA?

MACRA is the Medicare Access & CHIP Reauthorization Act of 2015 released by CMS. It is used to generate a new form of reimbursement and reward for care providers for the quality of care rather than quantity. MACRA implemented the Quality Payment Program (QPP) which is responsible for the simplification of Medicare Reporting Programs. MACRA is a permanent change to the system, therefore providers should be prepared to participate and MDLand is here to help you transition.

There are two ways to participate in QPP, either through Merit-based Incentive Payment System (MIPS) or Advanced Alternated Payment Models (APMs).

*Providers must participate in either MIPS or APMs to avoid penalties and receive bonuses or reimbursements.

Merit-based Incentive Payment System (MIPS)

By participating in MIPS, you are rewarded for value and outcomes through a performance-based payment adjustment. The payment adjustment is measured through the data clinicians report in four categories.

Information technology and health information exchange ensure that patients receive the best possible care from their primary providers. The exchange of data will ensure that providers are up to date with their patients’ health and able to check on them when needed. PCMH Recognition Program is the most widely adopted evaluation program in the country. This recognition enhances your commitment to your patients to provide the highest quality care with a patient-centered approach.

With a wide selection of CMS-approved clinical quality measures, primary care providers and specialists can improve their quality score. As a leading Meaningful Use Stage 3 (MU3) certified EHR technology (CEHRT), iClinic® Comprehensive EHR meets the requirements for advancing care information (ACI). Furthermore, the PCMH 2017 prevalidation can help you achieve Clinical Practice Improvement Activities.

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Advanced Payment Models (APMs)

Alternative Payment Model (APM) is a payment approach that gives providers added incentive payments to provide high-quality and cost-efficient care for different clinical conditions, populations or types of care.

You can participate in APMs through Bundled Payments for Care Improvement (BPCI) for the 2018 performance year.

BPCI is an initiative to improve care for Medicare patients, and is designed to lower costs and lead to higher quality care. Bundled payments act as an incentive for physicians, hospitals and other providers to work closely together to provide better care to beneficiaries.

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APMs consist of Accountable Care Organizations (ACOs) and Bundled Payment Models.

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