Medicare Compliance & Reimbursement - 2017 Issue 2
MACRA: MACRA Pick Your Pace Options
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Article Overview
This article covers CMS guidance on MACRA for emergency and hospital-based clinicians, focusing on the MIPS quality and clinical practice improvement categories, the 2017 transitional participation options, and how composite performance scoring and payment adjustments are structured. It is relevant for physicians, emergency medicine groups, billing and coding professionals, and practice leaders who need a high-level understanding of the reporting categories and program pathways discussed in the MACRA final rule.
Why This Topic Matters
MACRA changes how clinicians are evaluated and how payment adjustments are determined, so understanding the reporting categories and participation options helps emergency groups assess their readiness for the transition year and the broader Quality Payment Program.
Article Sections
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How Will Emergency Groups Meet The Quality and PI Category Requirements?
This section discusses CMS guidance for emergency physicians and hospital-based providers under MACRA. It covers the quality category, clinical practice improvement activities, and broad areas of focus for reporting and attestation.
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CMS "Pick Your Pace" Plan allows Four Options for MIPS
This section outlines the transitional year participation paths described by CMS. It summarizes the general framework for different levels of 2017 data submission and the resulting payment adjustment possibilities.
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MIPS Scoring and the Composite Performance Score
This section explains the overall MIPS scoring framework and how performance is compared against a benchmark. It also addresses the broader structure used to determine payment adjustments and bonus potential.
What You Will Learn
- How MACRA guidance applies to emergency medicine and hospital-based providers
- What broad categories are involved in MIPS reporting and improvement activities
- What the CMS transitional participation paths are for the 2017 performance year
- How MIPS scoring relates to a composite performance score and benchmark comparison
- How payment adjustments are generally tied to performance under the program
Who Should Read This
- Emergency physicians
- Emergency medicine group leaders
- Hospital-based clinicians
- Medical coders and billers
- Practice administrators
- Revenue cycle professionals
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