American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

Medicare Payment Under MACRA

Forthcoming CMS payment model designed to reward quality, rather than quantity, of care

The Medicare Access and CHIP Reauthorization Act (MACRA) will incentivize quality and coordinated care among clinicians who treat Medicare Part B patients. The Centers for Medicare and Medicaid Services (CMS) will issue final details on how MACRA will work in early November 2016. Here's what you need to know about the new payment model as it's currently slated to work.

 

MACRA: Now with flexible options Video

CMS recently announced new flexibility for how physicians participate in MACRA in 2017. Watch this video to understand the four options for data reporting physicians can choose from in 2017.

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How you’ll be paid under MACRA Video

Physicians can choose between four pathways: testing, partial year reporting or full-year reporting in the Merit-Based Incentive Payment System (MIPS), or joining an advanced Alternative Payment Model (APM). 

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What can you do now to prepare?

Unless you're exempt, you'll need to report for the MIPS starting in 2018, even if you're participating in an APM. You can get a head start by addressing weaknesses you spotted during previous CMS reporting programs.

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Is MIPS right for you?

The Merit-Based Incentive Payment System (MIPS) streamlines existing CMS reporting programs. Physicians will receive rewards or penalties based on how their scores compare to their peers' performance in four areas.

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Is an APM right for you?

Advanced Alternative Payment Models (APMs) offer a 5% bonus from 2019 to 2024. APMs also require practices to take on two-sided financial risk.

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Is there an APM for primary care?

Primary care physicians have until Sept. 15, 2016, to apply for the Comprehensive Primary Care Plus (CPC+) advanced alternative payment model. Those selected will start participating in 2017 and remain in the program for five years.

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What's the MACRA timeline?

Learn how your pay will differ in the long term based on whether you participate in the Merit-Based Incentive Payment System (MIPS) or join an advanced Alternative Payment Model (APM).

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