MACRA, which replaces the flawed Sustainable Growth Rate (SGR), establishes new quality reporting programs aimed at encouraging value-based care.
APA staff will be analyzing the final rule and its implications for APA members. Right now, psychiatrists should be aware of the following:
- Psychiatrists with up to $30,000 in Medicare billings or 100 Medicare patients will be exempt from quality reporting and payment adjustments under the MIPS program.
- Psychiatrists can ease into MIPS reporting in 2017 due to relaxed “Pick Your Pace” reporting for that year. Reporting just one measure for Quality, one Clinical Practice Improvement Activity, or all measures for electronic health record (EHR) use will avoid 2019 penalties. Reporting complete MIPS data for part (or all) of 2017 can earn modest (or slightly higher) bonuses in 2019.
- Psychiatrists who do MIPS reporting for 2017 will not be penalized for seeing sicker, lower income patients. Their Medicare patients’ resource use will not be counted in their MIPS score.
- Psychiatrists will only have to report four medium-weight or two high-weight Clinical Practice Improvement Activities and only five Advancing Care Information measures (for EHR use) to get credit in those categories—a significant drop from the proposed rule.
The downloadable APA MACRA Toolkit may include resources such as:
- MACRA 101 Primer
- Decision tree to help psychiatrists choose their payment pathway
- Checklist and timelines to get ready for MIPS
- Additional APA and other resources to help members prepare
- Quality 101 Reporting—This will be available in late October
- Final Rule Overview—November 16, 2016
- MIPS Quality Category—November 30, 2016
- MIPS Advancing Care Information Category—December 7, 2016
- MIPS Clinical Practice Improvement Activities Category—December 14, 2016
- Alternative Payment Models—January 18, 2017
For more information, see upcoming issues of Psychiatric News and the series of Psychiatric News articles on MACRA and value-based care.