The Centers for Medicare & Medicaid Services (CMS) has released guidelines for implementing the Medicare Access and CHIP Reauthorization Act (MACRA) which will place most physicians in the pay-for-performance Merit-Based Incentive Payment System (MIPS) beginning in 2019.
MIPS will adjust payments based on measures derived from prior care. Physicians can be exempt from MIPS and receive bonus payments by demonstrating sufficient participation in advanced alternative payment models (APMs).
Writing in the June 14 issue of JAMA, Jeffrey D. Clough, M.D., and Mark McClellan, M.D., Ph.D., both of Duke University, say that physicians should understand the key features of the law and changes that lie ahead.
“Despite its size and scope, the rule leaves many questions unsettled, including certainty about the best pathways forward for many types of physicians, and how much influence the reforms will have on quality of care and spending for Medicare beneficiaries. Physicians now have a critical opportunity to improve the proposal and develop and implement reforms to maximize its effectiveness,” they wrote.
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Please click on the following image to view a summary of the MIPS composite performance score.