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#70929 - 03/02/17 09:42 PM If you read nothing else about MIPS/MACRA please read this
JBS Offline
Member

Registered: 09/20/09
Posts: 2455
Loc: Baltimore, MD
It is easy to be turned-off by the entire MIPS/MACRA program, and to decide not to participate. You can not only skip all of the hoops of participation, but you also don't need to waste time learning how the program works or any of the minutiae of the program requirements. I think that would be a mistake though because you can very easily avoid a cut to your Medicare income in 2019 with a minimal amount of effort.

First, a brief explanation. MIPS/MACRA is designed to simplify the CMS incentive/punishment programs. Beginning in 2017, there is no more MU, PQRS, eRx, or value based modifiers... they are all combined into MIPS. The program, its components, and the program requirements are still voluminous and complex. A key point for 2017 is that our activities this year determine a pay cut or raise between -4% and +4% on our Medicare payments for 2019. Without going into detail here, getting any bonus will be difficult. Even if you participate for all 365 days of 2017, in all the components of the program, there is NO guarantee that you will get a 4% bonus. Even with year-long, perfect participation, a much smaller bonus is likely. Medicare states this very clearly. What IS guaranteed is that if you do NOTHING, then you will have a 4% cut in 2019.

The good news is that you can break even and avoid that 4% cut with a minimal amount of work. CMS has decided to offer a "test" path for 2017. Participation in the test path will not get you any bonus but it will avoid any cut. Participation involves a minimal amount of work. Theoretically, submitting a single Medicare claim with the appropriate added codes will be regarded as successful test participation, and you avoid the 4% penalty. For safety, you may choose to do more than one claim, but the requirements are minimal. How do you know what codes to pick? I will be happy to discuss that in future posts, but there are many easy choices.

AC is doing an excellent job of trying to organize this information and you will be hearing more about this as the year goes on. That is especially important if you plan to participate more fully than what I describe here.

For more details on the test path and how to navigate it, AC has prepared an excellent summary which you will find here. It contains a large amount of information condensed into a small space, but I would suggest that you focus on the "Quality Measures" section, which they mark as the "easiest option" and then use the "claims" method of submission (which is quick, easy and free).

So for now, you need do absolutely nothing. Simply resolve that before the end of the year, you will spend a few minutes reading here which codes will save you the 4% cut, and then submit a few claims with the added codes. If you object to this program on moral or political grounds, then that of course is your choice. To lose 4% because it is "too much work" or "too hard to figure out"... that, I think, would be a mistake.
_________________________
Jon
GI
Baltimore

Reduce needless clicks!

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#70932 - 03/03/17 09:33 AM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
koby Offline
Member

Registered: 05/14/09
Posts: 527
Loc: Canaan CT
Jon thanks for this 'Pep Talk' post on MIPS

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#70954 - 03/14/17 08:47 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
Michigan Offline
Member

Registered: 10/22/12
Posts: 29
Loc: Michigan
So just to clarify if we are doing the test path and do a quality measure we don't have to pay for the security risk analysis to be done?
_________________________
Northern Michigan
Neurology Clinic

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#70960 - 03/15/17 03:09 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
JBS Offline
Member

Registered: 09/20/09
Posts: 2455
Loc: Baltimore, MD
That is correct.
You can avoid the 4% cut with a quality measure which has no security analysis requirement.

An alternative is the "advancing care information" path which has 4 requirements; three of them are pretty easy, but the fourth is the security risk analysis which is either a hassle or an expense. That is why I think the quality measure is the easiest way to go.
_________________________
Jon
GI
Baltimore

Reduce needless clicks!

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#71064 - 04/10/17 12:42 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
melgulledge Offline
Member

Registered: 04/25/16
Posts: 4
Good Morning Amazing Charts Users!
I was wondering if anyone had any advice on which registries to use?
I have used PQRS Wizard in the past, and found it very user friendly.
Please help w/ this! I am at a loss as to which to use.
I have looked into MDInteractive, but it seems very complex.
Any help would be appreciated!
MGulledge, CMA, CPC
South GA Internal Medicine, PC

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#71065 - 04/10/17 02:14 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
[email protected] Offline
Member

Registered: 05/14/12
Posts: 149
Loc: North Kingstown, RI
Hi MGulledge,

If your having trouble selecting a registry, you can contact a service called Elixir. Elixir is a matching service that takes your practice and matches you to the appropriate registry. Its kind of like a dating service between practices and registries.

For more information, you can email [email protected] Please note that it takes about 6 weeks to get up and running with a registry, so I would recommend contacting them ASAP.

I hope that helps.
_________________________
Mark Dabeck
Training Specialist/Amazing Charts
"Amazing Charts now offers On-Site Training. Message me for details".

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#71086 - 04/19/17 04:45 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
Boondoc Offline
Member

Registered: 01/13/10
Posts: 998
Loc: Alaska
The old MU system has been discontinued with no real admission from the responsible parties concerning its abject failure and the waste of not only billions of dollars of taxpayer money, but the meaningless disruption in the lives of thousands of doctors and others involved in healthcare.

If you ever want the madness to end, you have to stand up and choose that you are not going to participate with any more similar schemes. If enough of us did this, they would realize they could not manipulate us in this way.
_________________________
Chris
Living the Dream in Alaska

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#71087 - 04/19/17 05:38 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
todd Offline
Member

Registered: 10/26/11
Posts: 302
Loc: Findlay, Ohio
I told PQRS this year to stick it in the same hole as a colonoscope....
_________________________
Todd A. Leslie, D.O.

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#71097 - 04/19/17 08:47 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
Like the bird Offline
Member

Registered: 07/30/10
Posts: 4
Loc: Richmond VA
We are having problems with the counting of mammograms in AC. Our results are faxed over so there is no LINC code as you would have with a lab result that is imported.
Honestly, we haven't spent a lot of time on this until recently when we are working on Care Gaps and decided to use this measure for MIPS.
We have the order entered for Mammogram.
We have the faxed Mammogram result reconciled,reviewed by physician and in imported items.
Is there a way to have this show up on MU/MIPS reports when we run?
Is there another way to collect these numbers with available reports in AC?
We can't be the only Practice having this issue.
Is there something that we are missing?
I would appreciate any guidance available on how to acheive the counts needed.

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#71101 - 04/20/17 12:01 AM Re: If you read nothing else about MIPS/MACRA please read this [Re: Like the bird]
Indy Offline
Member

Registered: 06/23/09
Posts: 1648
Loc: Western US
Originally Posted By: Like the bird
We are having problems with the counting of mammograms in AC. Our results are faxed over so there is no LINC code as you would have with a lab result that is imported.
Honestly, we haven't spent a lot of time on this until recently when we are working on Care Gaps and decided to use this measure for MIPS.
We have the order entered for Mammogram.
We have the faxed Mammogram result reconciled,reviewed by physician and in imported items.
Is there a way to have this show up on MU/MIPS reports when we run?
Is there another way to collect these numbers with available reports in AC?
We can't be the only Practice having this issue.
Is there something that we are missing?
I would appreciate any guidance available on how to acheive the counts needed.


MU/MIPS automated reports are only going to show those types of measures if there is a place in AC to store and "check" that it was done.

I know that coming releases are supposed to be responsive to new requirements - time will tell.

On the other hand, if you can attest manually, or without using EHR output, you have other options.
_________________________
Indy
"Boss"

Indy's Blog

www.BestForYourPractice.com
Our Name is Our Creed

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#71193 - 05/04/17 02:36 AM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
Boondoc Offline
Member

Registered: 01/13/10
Posts: 998
Loc: Alaska
I got their nifty little letter saying I have to participate in the program or lose up to 9% by 2022. It also said if I had less than 100 Medicare patients or less than 30,000 per year in billing I'm exempt. That is supposed to be relief for small practices, but it's a pretty small number. I spent 45 minutes on the phone with them asking how I can inform them if I drop below 100 patients, but they could not answer the question. I told the strongly that I'm not playing any more of their games. Please tell me you are not all going to try MU round 2?
_________________________
Chris
Living the Dream in Alaska

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#71200 - 05/05/17 04:09 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: JBS]
SybridMD1 Offline
Member

Registered: 02/02/17
Posts: 3
Loc: Bellmore, NY
There is a webinar arranged for the knowledge and implementation of MACRA

https://sybridmd.com/WebinarDetail.aspx/...tm_medium=email

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#71247 - 05/31/17 06:19 PM Re: If you read nothing else about MIPS/MACRA please read this [Re: Like the bird]
lynn Offline
Member

Registered: 08/27/05
Posts: 68
Loc: RI
one way to do this is might be to use the PRIME registry
I have half of my mammograms faxed over and the others are imported with EDI codes
they have mapped my practice so that when the word " mammogram" or " mamm" appears in the name of the imported item, it picks it up
also they have mapped my electronically imported files so that
" tomosynthesis screen with CAD and "b/l scrn Mammo"
are picked up by the registry

unfortunately I cannot tell you how well it is working since I have hit a glitch over the past month and the registry is inoperable

I do fully expect it to work and my mammogram rate should shoot up to the 76% that it is by hand, as opposed to the 3% which it is counting now

I'll let you know when the system becomes operational again.
_________________________
Lynn

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