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Dec 14

Navigating the Quality Payment Program’s Sea of Acronyms

MACRA? MIPS? APMs? Don’t get lost in the QPP Sea of Acronyms. Most clinicians will be best served to maintain focus on the here and now: PQRS.

Since the Final Rule for the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was published in October, all the talk in healthcare has been on compliance with the latest Quality Payment Program initiative. MACRA repeals the Sustainable Growth Rate, creates the Merit-Based Incentive Payment System (MIPS), and provides incentive payments for participation in Advanced Alternative Payment Models (APMs).

And while MACRA/MIPS/APMs may be a growing concern for tomorrow, providers are still responsible for maintaining compliance with Physician Quality Reporting System (PQRS) today, and should be leveraging the appropriate registry solutions that will help them avoid costly penalties.

Data reported through PQRS registries provides participating eligible professionals (EPs) and group practices (GPs) with objective, actionable feedback on their use of measurable data to improve the quality and efficiency of patient care. Participating clinicians are better able to quantify how often they are meeting a specific quality metrics and compare that performance against peers so they can assess quality of care, make adjustments, and employ a more evidence-based approach to medicine.

PQRS has transitioned from an incentive-based program to a punitive one for eligible clinicians that do not satisfactorily report data on quality measures for covered Medicare Physician Fee Schedule services furnished to Medicare Part B Fee-for-Service beneficiaries. The deadline for 2016 claims to be processed and counted for PQRS reporting to determine the 2018 payment adjustment will be in late February 2017 – which means those who report satisfactorily for the 2016 program year will avoid the 2018 PQRS negative payment adjustment from CMS.

PQRS measurement options and reporting guidelines can be overwhelming, but consultative experts and the right CMS-qualified registry can help guide both EPs and GPs through effective PQRS compliance. Visit Practice Insight’s PQRS Registry Solution, powered by Alpha II and integrated with EDIinsight® for more information or contact the MicroMD eSERVICES Team to discuss if this solution is a fit for your practice.

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