CMS proposes changes to MACRA Quality Payment Program for 2018

The Center for Medicare and Medicaid Services (CMS) on June 30, 2017, published a proposed rule outlining changes for the 2018 performance year of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA’s QPP includes the incentive payments for advanced alternative payment models (A-APMs) and the Merit-based Incentive Payment System (MIPS). Performance in 2018 will determine payment adjustments to clinicians that will be applied to their Medicare Part B payments in 2020.

The first performance year began January 1, 2017, for Part B payment adjustments in 2019.

MACRA repealed the sustainable growth rate (SGR) formula for updates to the Medicare Part B Physician Fee Schedule and sets payment updates for all years in the future. Through the QPP, the law is intended to link Medicare payment updates to quality and performance and drive the health care payment system across all payers away from fee-for-service reimbursement models.

Select key provisions of the proposed rule are highlighted below.

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CMS continues push to offer additional Advanced APM options under MACRA

The Centers for Medicare and Medicaid Services (CMS) on Tuesday, October 25, 2016, announced additional options for physicians and other clinicians paid under the Medicare Part B Physician Fee Schedule (PFS) to participate in Advanced Alternative Payment Models (Advanced APMs) in 2017, the first performance year under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS also announced additional options for clinicians to participate in Advanced APMs in 2018.

Under MACRA, Advanced APMs are risk-bearing, coordinated care models that link reimbursement to certain quality and outcomes measures and require the use of certified electronic health record technology (CEHRT).

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