|Quality Payment Program Updates|
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, and the Centers for Medicare & Medicaid Services (CMS) then replaced it with the Quality Payment Program. Remember – the Quality Payment Program has two tracks you can choose: Advanced Alternative Payment Models (APMs) OR the Merit-based Incentive Payment System (MIPS). AAOS has shared the details of QPP and MIPS, which can be found on our website, here: www.aaos.org/MACRA_QualityPaymentProgram/ and here: www.aaos.org/MACRA-DeliveryReform/.
CMS has designated 2017 as a transition year for quality reporting under MIPS, allowing providers to take advantage of the “Pick Your Pace” option in MIPS. There are four options during this transition period:
- No reporting: incurs a -4% payment adjustment
- Submit something to avoid a penalty: a single quality measure for a single patient qualifies
- Submit partial year: submit data for a 90-day period
- Submit a full year: submit data for full year
Those providers who submit partial or full-year data can potentially earn a positive payment adjustment. However, to avoid incurring a penalty, submission of a single measure is required. The American Medical Association (AMA) recently shared an educational tool, entitled “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting,” which includes a short video offering simple instructions for reporting.
Additionally, CMS recently sent out letters to notify providers whether they had been slated to participate in MIPS. If you have not received a letter from CMS regarding MIPS eligibility, you may use an interactive tool on the CMS Quality Payment Program website to determine if you should participate in 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on the tool which can be found on the Quality Payment Program website at https://qpp.cms.gov/. Information will then be provided on whether you should participate in MIPS this year and where to find resources.
To get the latest information from CMS, visit the Quality Payment Program website. The Quality Payment Program Service Center may be reached at 1-866-288-8292 (TTY 1-877-715- 6222), available Monday through Friday, 8:00 AM-8:00 PM ET or via email at QPP@cms.hhs.gov.