MACRA: Prepare Now for Possible MIPS Low-Volume Threshold Changes in 2018 and Beyond

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains proposed MACRA Quality Payment Program changes for 2018 and beyond, focusing on how CMS may adjust MIPS participation thresholds, reporting burden, and related program structure for Medicare Part B clinicians. It is relevant to physicians, small practices, rural and underserved providers, practice managers, and coding or compliance professionals monitoring payment reform developments and transition-year guidance.

Why This Topic Matters

The proposed changes could affect which clinicians must report under MIPS, how small or low-volume practices are treated, and how future participation options may be structured. Understanding the proposal helps practices anticipate compliance and reimbursement impacts without relying on year-old assumptions.

Article Sections

  1. Background and proposed rule context

    Introduces the CMS proposed rule for the next program year and summarizes the general themes of the update. It places the discussion in the broader transition from older Medicare payment policy to the Quality Payment Program.

  2. Name change note

    Explains a terminology update used by CMS to distinguish the program year. The section frames how CMS is labeling the next stage of the program.

  3. Are You Subject to MIPS Reporting?

    Discusses participation and exemption questions under MIPS for the transition year and the proposed next-year changes. It focuses on low-volume threshold concepts for Medicare Part B clinicians.

  4. Mixed reviews

    Summarizes reactions and concerns raised about the proposed threshold changes. The section also reflects on potential effects for clinicians and practices near the eligibility boundary.

  5. The positive

    Covers commentary on CMS responsiveness and the expected impact on smaller and underserved provider groups. It addresses how the proposal may affect participation levels and overall program reach.

  6. Note These New Developments

    Outlines additional proposed developments for future performance years, including possible changes to participation options and threshold structure. The section also touches on longer-term program goals.

What You Will Learn

  • How CMS is proposing to update the Quality Payment Program for the next year
  • What kinds of threshold-related changes may affect MIPS participation
  • How the proposal may influence small-practice and low-volume clinician reporting burdens
  • What future participation flexibility CMS is considering for later performance years
  • How stakeholders and industry observers are reacting to the proposed changes

Who Should Read This

  • Medicare Part B clinicians
  • Physicians and small group practices
  • Practice administrators
  • Coding and compliance professionals
  • Healthcare reimbursement and policy readers

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