Medicare Compliance & Reimbursement

You have two short months to prep for the implementation of MACRA’s final rule.

As CMS begins its massive shift toward MACRA’s Quality Payment Program (QPP) that is set to begin Jan. 1, 2017, Meaningful Use (MU) will be replaced with Advancing Care Information (ACI). The QPP and its technical element support efficiency and ease for providers as Medicare transitions to a quality-based, coordinated-care system, putting the patient first and enriching the practice of medicine in the process.

Outline. Because it is financially precarious over the long haul to ignore the new payment regime and accept the new quality standards, CMS put forward four paths to success under the QPP, hoping to quell provider worries over the transition. In the MACRA final rule that came out on Oct. 14, 2016, CMS solidified the ACI category with a marked decrease in requirements and burdens from its original proposal last April. (Read the final rule here: https://www.federalregister.gov/documents/2016/11/04/2016-25240/medicare-program-merit-based-incentive-payment-system-and-alternative-payment-model-incentive-under.)

CMS Eases ACI Assessments

Unfortunately, many providers are unaware of the changes affecting health IT with MACRA or aren’t up-to-date with their reporting and practice CEHRT. Due to the various opportunities to ease into the QPP and adopt the mandates under ACI, there is still time to fully analyze what you can do and what’s at stake.

Here are four key points to know that have changed since the original proposal and that will make your switch from Stage 3 of MU to ACI sweeter:

1. Physicians need to only report on five interoperability measures under ACI.
2. The ACI reporting period minimum has been shortened from the originally proposed time period of one year to just 90 days.
3. Providers are incentivized for care coordination, public health reporting, and more.
4. The program is customizable, focused on patient engagement, and caps at 100 percentage points and weighted at 25 percent of the overall MIPS score.

ACI exemptions. Unlike MU, the new health IT initiative allows for provider exemption. Providers who utilize advanced APMs, are in their first year with Medicare, and/or have low Medicare volumes will qualify for an ACI exemption.

Resource. For more information on ACI and the role of health IT under MACRA, visit https://www.healthit.gov/sites/default/files/macra_health_it_fact_sheet_final.pdf.