macra - american college of rheumatology · pdf filemacra signi˜cantly changes how...

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MIPS APMs MACRA Medicare Access and CHIP Reauthorization Act of 2015 AT A GLANCE MACRA significantly changes how Medicare will reimburse rheumatologists and their practices in the future, and emphasizes quality, value, and physicians taking more financial risk. APMs Alternate Payment Models Advancing Care Information (MU) Electronic health record Value-based Modifiers PQRS Physician Quality Reporting System Quality Resource Use Clinical Practice Improvement Advancing Care Information (MU) Electronic health record Three separate systems Four categories, one composite score and report Payment models that incentivize providers on quality, outcomes, and cost containment ACOs Accountable care organizations Bundles Bundled payment models Medical Homes Patient-centered medical homes Other Models Under development To earn a bonus and avoid penalties, you must successfully participate in MIPS or APM. MIPS Merit-based Incentive Payment System PRESENT FUTURE rheumatology.org/MACRA Extends CHIP Children’s Health Insurance Program SGR Shifts FFS to P4P Medicare shifts from fee-for-service to pay-for-performance Big Ideas About MACRA Choose Payment Pathway MIPS or APM Repeals SGR Sustainable Growth Rate MIPS and APMs will go into effect over a timeline from 2015 through 2021 and beyond.

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Page 1: MACRA - American College of Rheumatology · PDF fileMACRA signi˜cantly changes how Medicare will reimburse rheumatologists and their practices in the future, and emphasizes quality,

MIPS

APMs

MACRAMedicare Access and CHIP Reauthorization Act of 2015

AT A GLANCE

MACRA signi�cantly changes how Medicare will reimburse rheumatologists and their practices in the future, and emphasizes quality, value, and physicians taking more �nancial risk.

APMsAlternate Payment

Models

Advancing CareInformation (MU)Electronic healthrecord

Value-basedModi�ers

PQRSPhysician QualityReporting System

Quality

Resource Use

Clinical PracticeImprovement

Advancing CareInformation (MU)Electronic healthrecord

Three separatesystems

Four categories, onecomposite score and report

Payment models that incentivizeproviders on quality, outcomes,

and cost containment

ACOsAccountable careorganizations

BundlesBundled payment models

Medical HomesPatient-centeredmedical homes

Other ModelsUnder development

To earn a bonus and avoid penalties, you must successfully participate in MIPS or APM.

MIPSMerit-based Incentive

Payment System

PRESENT FUTURE

rheumatology.org/MACRA

ExtendsCHIPChildren’s HealthInsurance ProgramSGR

Shifts FFS to P4PMedicare shifts from fee-for-service to pay-for-performance

Big Ideas About MACRA

Choose Payment PathwayMIPS or APM

RepealsSGRSustainableGrowthRate

MIPS and APMs will go intoe�ect over a timeline from

2015 through 2021 and beyond.

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