Medicare Quality Payment Program Year Two Proposed Rules

Many of you may have attended the Medicare MACRA/MIPS Year 2 Proposed Rule Overview this week. I just wanted to highlight a few of the major points:

  • Low Volume Threshold: Increase to >= $90,000 in Medicare claims or >= 200 Medicare patients

  • Additional Bonuses
    • Small Practice Bonus <= 15 providers (5 points) 
    • Health Care Shortage Area Bonus (5 points)
    • Potential adjustment for patient complexity (1 – 3 points)
    • Scoring Improvement Bonus (up to 10 points)
  • Virtual Groups – Allow small practices with 10 or less clinicians and different TINs to come together in a group for reporting purposes. This must be declared before the beginning of the performance period, so prior to December 1st, 2017 for a virtual group in 2018.
  • Performance Categories
    • Quality – Remains at a 60% portion of the final score with a 12 month reporting period
    • Cost – Proposed to be 0% again
    • Improvement Activities
      • 15% towards final score,
      • can choose a 90-day period,
      • more activities will be added to the list of those eligible for the 10 ACI bonus points
    • Advancing Care Information
      • 25% towards final score,
      • allow 2014 or 2015 CEHRT again for 2018; however, bonus points for providers that use 2015 CEHRT,
      • can choose a 90 day reporting period
      • additional bonus points for registry reporting (10 instead of just 5)

These are just some important tidbits. MACRA/MIPS money is so accessible this year, do not miss your opportunity!

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