American Osteopathic Association

Advancing the distinctive philosophy and practice of osteopathic medicine

What can you do to prepare for MACRA?

Gear up for MACRA by positioning yourself to excel in MIPS and reading up on MACRA's other pathway, APMs.

In 2017, if you participate in any way in the Merit-Based Incentive Payment System (MIPS), you'll avoid penalties and may be eligible for a small or modest incentive payment depending on your performance and how much data you submit. If you're in your first year of Medicare or care for 100 or fewer Medicare patients and have less than $10,000 Medicare charges annually, you're exempt from  MIPS. 

Because MIPS streamlines and expands on current CMS quality reporting systems, you can prepare by taking the following steps:

  • Assess your electronic health record (EHR) system. Is it meeting your patient care needs? Were you able to attest for Meaningful Use successfully? Ask your vendor if your EHR is certified and whether it will allow you to report for the quality and clinical practice improvement activities (CPIA) category of the MIPS. Also ask what edition your EHR is, whether the vendor plans to upgrade to 2015-edition certified EHR tech, and what costs will be involved with upgrading. The Health IT Playbook can help you assess your EHR needs and potential purchases.
  • Analyze your practice's performance under previous CMS reporting programs—the Physician Quality Reporting System (PQRS), Meaningful Use of Electronic Health Records (MU), and the Value-Based Payment Modifier (VBPM)— and address any weak spots.

  • Consult your practice's quality and resource use report to identify the most common and costly patient conditions you treat. Consider how you might be able to provide more efficient, coordinated care for those patients.
  • Familiarize yourself with MIPS’ new category, Clinical Practice Improvement Activities (CPIA), by reviewing the list of approved activities, figuring out which ones you can do well, and making any needed workflow changes.

  • Check in with your colleagues: Do you want to report for MIPS as a group, or as individuals? Comparing performance reports can help you decide.
  • Learn about advanced Alternative Payment Model (APM) options and requirements if you’re considering that pathway.

  • Share your thoughts about the new payment system. The AOA has submitted a comment letter about MACRA and is engaged in ongoing conversations with the CMS. To share your concerns and recommendations, please email

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