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What are MACRA and MIPS?

27 August 2018
Blog

eClinicalWorks

Since 2016, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Merit-based Incentive Payment System (MIPS) have been changing the healthcare reimbursement landscape. Now, providers have largely adjusted to the new rules, are meeting the reporting requirements, and have turned their attention to finding ways to improve their performance.

How to Succeed in 2018 and Beyond

1. What is MACRA?
2. What is MIPS?
3. What should I be doing now to get ready?

eClinicalWorks is here to help. To help explain it all, we sat down with eClinicalWorks Senior Analyst Pooja Shah to find out what’s new, what’s changed, and what providers need to know to continue to thrive.

Fast Facts for 2018:

Who should report for Year Two: Physicians, Nurse Practitioners, Physician Assistants, Clinical Nurse Specialists, and Certified Registered Nurse Anesthetists.

Score some bonus points: Listen to our latest podcast to see how you can gain bonus points and avoid a negative payment adjustment.

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What are the 2018 exemption criteria?

You are exempt if you:

Are newly enrolled in Medicare.
Meet a low-volume threshold of $90,000 or less in annual Medicare-allowed charges and have seen 200 or fewer patients.
Participate in an Advanced APM as a Qualifying Participant.

Quality reporting period has changed: The reporting period is now a full calendar year instead of just 90 days.

There’s something new: Cost has been added as a category.

Topped-out measures: You can only get seven points on a topped-out measure; eClinicalWorks can help providers determine if these measures are a good fit or if you should seek points in a different category.

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How Can eClinicalWorks Help?

We have an entire team at eClinicalWorks devoted to helping you succeed with MIPS and MACRA.
MIPS Dashboard – with the eCW dashboard, providers can see and track their performance each week based on the data captured in their Progress Notes.
The Centers for Medicare & Medicaid Services (CMS) has a great lookup tool on the Quality Payment Program (QPP) website where providers can enter the NPI to see if it meets the low-volume threshold and/or if they are part of any Advanced Alternative Payment Model.