If you combine the current PQRS and Meaningful Use programs into one, along with a side of additional reporting, you basically have MACRA. The three performance categories are:
QUALITY – Accounts for 60% of your score. This replaces PQRS.
ADVANCING CARE INFORMATION – Accounts for 25% of your score. This replaces Meaningful Use.
CLINICAL PRACTICE IMPROVEMENT ACTIVITIES – Accounts for 15% of your score. This is a new program.
If a practice is completely non-compliant next year in reporting, they will see an impact on their Medicare reimbursement. A practice can have an adjustment of 4% up or down in 2019 (based on reporting year 2017), 5% in 2020, 7% in 2021 and finally 9% up or down in 2022 and beyond. If you have a qualified EHR, much of this reporting should be relatively easy. You may also need to add a qualified registry to further report some of the different measures. The measures we recommend for your consideration for each performance category are:
Quality:
Varicose Vein Treatment with Saphenous
Closing the Referral Loop: Receipt of Specialist Report
Documentation of Current Medications in the Medical
Patient-Centered Surgical Risk Assessment and Communication
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Surgical Site Infection (SSI)
Advancing Care Information – The first four are required elements and the other two are our recommendations for consideration:
e-Prescribing
Health Information Exchange
Provider Patient Access
Security Risk Analysis
Patient-Specific Education
View, Download, or Transmit (VDT)
Clinical Practice Improvement Activities – There are 93 Activities in which a practice can participate. If your group has fewer than 15 practitioners, then you only have to select two of them. You can find more information along with full definitions of the other measures at https://qpp.cms.gov/
Medicare is allowing practices to ease into the MACRA program. You will not have to do a full year’s reporting in 2017. We do recommend that you try to report for at least three months though. Some of the measures are just good care while some will be a bit onerous for a small practice. You will need to weigh out the costs of non-compliance against the cost of compliance and reporting.
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