Who Needs to Report Now
You must first determine if you need to report MIPS data. According to Medical Economics, CMS granted a temporary reprieve to over 800,000 physician practices for 2017 compliance. However, this relief is temporary and only applies to 2017. Physicians should prepare now for MACRA and MIPS requirements starting in 2018 to avoid future penalties.
Providers exempt from reporting for 2017 include:
- New Medicare Part B participants
- Clinicians with $30,000 or less in Medicare charges and 100 or fewer Medicare Part B patients
- Clinicians participating in an advanced Alternative Payment Model (APM)
If you haven't received a notification from CMS about your reporting status, you can check your MIPS eligibility using your National Provider Number (NPI) on the CMS verification tool.
Approximately 419,000 clinicians who do not meet these exemptions must report MIPS data for 2017, including:
- Physicians (MDs, DOs, DPMs, chiropractors)
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Certified registered nurse anesthetists
- Clinical groups including these professionals
Getting Started
MACRA aims to streamline value-based programs such as Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Payment Modifier (VBM). There are two participation tracks for the Quality Payment Program:
Advanced Alternative Payment Model (APM): Includes models like Comprehensive ESRD Care, Comprehensive Primary Care Plus, and Next Generation ACO Model.
MIPS: Offers several reporting methods and three levels of participation. The deadline for 2017 data submission is March 31, 2018, to avoid significant penalties.
Providers selecting the MIPS track must decide their participation level and reporting methods. Options include full-year reporting or a partial-year option, which requires consistent recording for a continuous 90-day period starting by October 2, 2017. A minimum "test" level involves reporting at least one measure or activity to prevent a 4% payment adjustment in 2019.
Choosing What to Report
Providers have multiple reporting options, including:
- Quality (formerly PQRS)
- Improvement activities (new category)
- Advancing care information (formerly MU)
- Cost (formerly VBM)
Reporting methods include Qualified Clinical Data Registry (QCDR), qualified registry, EHR, claims, and attestation web portal. WCH can help identify the best reporting options for your practice.
Picking Your Pace
CMS offers three reporting options:
Full-year reporting: Report all required measures for all eligible patients for 12 months to potentially earn a positive adjustment.
Partial-year reporting: Submit data for a continuous 90-day period to earn a neutral or positive adjustment based on results.
Minimum “test” reporting: Report minimal data to avoid a negative payment adjustment, though this does not qualify for a bonus.
For more details, visit the Quality Payment Program website.
How WCH Can Help
Navigating MACRA and MIPS can be overwhelming. WCH offers support in selecting quality measures, establishing documentation processes, and ensuring MIPS compliance. Starting now is crucial to avoid penalties. For minimal reporting, simply document one performance measure or improvement activity per patient.
For providers reporting over a 90-day period, ensure documentation of six quality measures per patient visit, either through claims, an approved registry, or EHR. Improvement activities and advancing care information can be reported via attestation or QCDR.
WCH will assist you through the MIPS transition, providing updates and guidance. Contact your WCH account representative for tailored support and solutions. We’re here to simplify the process and ensure your compliance.
