MIPS/MACRA

This page is meant to serve as a basic information page for MACRA and MIPS.

What are MACRA and MIPS?

The Medicare Access and CHIP Reauthorization Act of 2015, otherwise known as MACRA, is a law that establishes new ways to pay physicians for caring for Medicare beneficiaries. In 2017 and going forward, MACRA and more specifically MIPS replaces PQRS and Meaningful Use as the primary Medicare reimbursement program. MACRA has two different reimbursement structures, but the one that will pertain to TRAKnet users is the Merit-based Incentive Payments System, or MIPS, which is a combination of several previous CMS incentive programs. For more information about MACRA and MIPS, visit the Quality Payment Program website, which also includes many educational resources. CMS has also hosted many presentations and webinars for MACRA/MIPS which can be found here.

Participation in MIPS is based off of four categories.

Quality

The Quality category effectively replaces PQRS from previous years; Quality will account for 60% of your overall MIPS Composite score.

For more information on how to perform the Quality category, click here.

Advancing Care Information

The Advancing Care Information or ACI category effectively replaces Meaningful Use from previous years; ACI will account for 25% of your overall MIPS Composite score. For the ACI fact sheet published by CMS, click here.

For more information on how to perform the ACI category, click here.

Clinical Practice Improvement Activities

Clinical Practice Improvements Activities. or CPI, is a new category; CPI will account for 15% of your overall MIPS composite score. CPI is based on things such as same day appointments, timely communication of test results, establishing care plans, after-hours access to clinicians, etc. For more information on CPI scores, click here.

For more information about how to perform the Improvement Activities category, click here.

Cost

Cost is a category that replaces the Value-Based Modifier. This category has no weight for your overall MIPS Composite score but will be weighted in 2018.

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