Maximizing Your Benefits from MACRA/MIPS

The long wait is over! On Friday, October 14, 2016, Centers for Medicare and Medicaid Services (CMS) released the final rule implementing The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The MACRA act establishes new ways to pay chiropractic physicians for caring for Medicare beneficiaries and will likely have an impact on your practice. This helpful guide breaks down the meaning of the rule and explains your options for ensuring you get the maximum benefit from the program starting in 2017. We’ll also make clear how and where ChiroTouch’s EHR software sets you up for successful reporting right from the start.

What is MIPS?

MIPS stands for “Merit-based Incentive Payment System”. The opportunity for MACRA/MIPS data reporting began on January 1, 2017. As it stands currently, each provider has the ability to choose how they will report to CMS for the incentive program.

With MIPS, you can earn a payment adjustment based on evidence-based and practice-specific quality data substantiating that you provided high quality, efficient care supported by technology. Information should be submitted in the following categories:

QUALITY REPORTING (PQRS)

What You Need to Provide: A minimum of 90 days of data, claims with medicare g-codes for chiropractic and one outcome measure using ChiroTouch macros.

‍The Benefit: Ninety-day reporting in this category may allow providers to avoid penalty or qualify for a small incentive. Reporting for a full year could result in a positive 4% payment adjustment, combined with other programs (such as ACI and CPI). A larger amount of points may be awarded based on achieving higher performance in the measure.

‍How ChiroTouch Helps You: Our comprehensive PQRS Macro set lets you achieve compliance with less effort. Set alerts for both staff and patients to ensure Outcome Assessments are completed in a timely manner. You can also use our Patient Sign-In tools to collect the patient subjective at the beginning of every patient visit.

ADVANCING CARE INFORMATION (MEANINGFUL USE)

What You Need to Provide: A minimum of 90 days of data, complete required measures, and bonus reporting using your ChiroTouch dashboard. Specialties may be excluded from certain measures that do not apply, but reporting measures remain the same for chiropractors. You must report at least one required measure to avoid penalty.

‍The Benefit: Ninety-day reporting in this category may allow providers to avoid penalties or qualify for a small incentive. Reporting for a full year could result in a positive 4% payment adjustment, combined with other programs (such as Quality and CPI).

‍How ChiroTouch Helps You: Use the EHR Dashboard to report Advancing Care measures. Clinical Practice Improvement will require that the provider implement a handful of CMS suggested improvements, outlined here.

CLINICAL PRACTICE IMPROVEMENT

What You Need to Provide: A minimum of 90 days of data and four improvement activities from the CMS list of suggested activities using your ChiroTouch dashboard. The four improvements should fit your specialty and practice type. Make sure you report at least one improvement to avoid a penalty!

‍The Benefit: Reporting four improvements (such as Quality and ACI) could result in a positive 4% payment adjustment. Bonus categories include use of CEHRT to complete CPI.

‍How ChiroTouch Helps You: We have selected a list of 50 suggestions that are accessible through your dashboard. Clinical Practice Improvement will require that the provider implement a handful of CMS suggested improvements, outlined here.

Am I Part of the MIPS Chiropractic Quality Payment Program?

You are a part of the Quality Payment Program if you are a physician, physician assistant, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist.

Do you bill Medicare less than $30,000 a year or provide care to less than 100 Medicare patients a year? Is 2017 your first year licensed? If you answered yes to either of those questions, then you are not in the MIPS data track of the Quality Payment Program. However, you can still participate in this program to gain reporting experience.

REPORTING AS A GROUP

A group is defined as a set of clinicians (identified by their NPIs) sharing a common Tax Identification Number, no matter the specialty or practice site. Groups will send in group-level data for each of the MIPS categories through the CMS web interface or an electronic health record, registry, or a qualified clinical data registry. To submit data through our CMS web interface, you must register as a group by June 30, 2017. If you submit your MIPS data with a group, the group will get one payment adjustment based on the group’s performance.

Your Tracks for Participation

At the present time, you can choose the pace at which you begin involvement in the Quality Payment Program. You could have started collecting performance data as of January 1, 2017. If you were not ready as of January 1, 2017, you can choose to start any time up to October 2, 2017. Regardless of when you choose to begin participating, you will need to make sure your performance data is submitted by March 31, 2018.

Track options for participation include:Submit Nothing: If you do not send in any 2017 data, then you will receive a negative 4% payment adjustment.

‍Submit Something: If you submit a minimum amount of 2017 data to Medicare (for example, one quality measure or one improvement activity for any point in 2017), you can avoid a downward payment adjustment.

‍Submit a Partial Year: If you submit 90 days of 2017 data to Medicare, you may earn a neutral or small positive payment adjustment.

‍Full Year: If you submit a full year of 2017 data to Medicare, you may earn a moderate positive payment adjustment.

You will be able to earn a positive MIPS chiropractic payment adjustment beginning January 1, 2019, if you submit 2017 data by March 31, 2018. Clinicians who achieve a final score of 70 or higher will be eligible for the exceptional performance adjustment. All MIPS-eligible chiropractors are compared to each other and held to a performance standard.