Physicians should have recently received a letter in the mail notifying them of their MIPS participation status, according to the Centers for Medicare & Medicaid Services (CMS). Some physicians, however, may be unaware of their participation status because CMS sent the notification letters to addresses linked to TINs, but not those affiliated with individual NPIs. If an individual physician is below the low-volume threshold, but the TIN decides to report as a group, the physician’s performance will influence the group’s performance score.
Under MIPS, physicians will attest to self-reported measures that are focused on clinical quality, technology and new approaches to care. Physicians can pick their pace of participation in MIPS this year. Doctors are required to report just one quality measure, one improvement activity, or the base Advancing Care Information measures this year to avoid a pay cut in 2019. Physicians who report nothing face a 4 percent pay cut in 2019. Doctors who do more than the minimum will have a chance to see an increase in pay in 2019.
Physicians who are not in the MIPS program in 2017 can participate voluntarily and not be subject to payment adjustments.
The CMS QPP website contains more information and resources for doctors. The AMA also has a Payment Model Evaluator to help physicians decide whether they should participate in the MIPS or Advanced APM track. In addition, the AMA offers resources to help physicians navigate MIPS, guidance to help physicians better understand what is required under MACRA and information to help doctors understand and participate in the Advanced APM track.
AMA Washington Counsel Ashley McGlone and Laura Hoffman, AMA assistant director of federal affairs, answered the top questions physicians have about MACRA during a recent ReachMD podcast. It is part of a podcast series, “Inside Medicare’s New Payment System.”