Medicare is changing the way it pays physicians and most other healthcare professionals. Depending on their
MACRA and MIPS
Congress passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to eliminate the “Sustainable Growth Rate” (SGR) and replace it with the “Merit-Based Incentive Payment System (MIPS).” Congress enacted MIPS to move Medicare from paying for volume to paying for value. MIPS is intended to promote the Triple Aim – better health, higher quality and lower cost.
Unfortunately, MIPS is extremely complex. From the standpoint of individual clinicians and their practices, there are numerous exceptions and alternatives, and the application and impact of those exceptions and alternatives will vary widely depending on practice demographics, specialty and current or proposed involvement in various Alternative Payment Models (APMs), among other things.
Because the 2018 performance period starts January 1, clinicians and their practice administrators need to plan now. Using the MIPS Navigator™ is an alternative to trying to decipher hundreds of pages of dense regulations.
The MIPS Navigator™ is an on-line tool that makes it possible for individual clinicians or practice administrators to quickly and easily sort through the various MIPS alternatives and produce a “2018 MIPS Itinerary/Plan” designed to maximize their potential 2020 MIPS bonus.
By answering a few questions specific to your practice, the MIPS Navigator™ will let you determine:
Assuming you will likely be subject to MIPS, the MIPS Navigator™ will produce:
Within the MIPS Navigator™ tool are hyperlinks you will find that can provide additional information on particular topics. The hyperlinks are identified by blue underlined text.
Finally, the MIPS Navigator™ licensees will have access to the tool for the full year. Your work is stored, so you can work on your MIPS Itinerary/Plan over time. You will also be able to create an amended plan should you reconsider and decide some changes may help increase your score.