MACRA Proposed Rule: MACRA, MIPS and APMs: The Proposed Rule Offers A Peek Into Future Reporting Requirements

Why This Topic Matters

The proposed rule signals major changes to how Medicare performance will be reported and scored, so practices need to understand the new framework to prepare for future reporting obligations and payment impacts.

Article Sections

1. Introduction and CMS proposal overview

   Introduces the CMS MACRA proposed rule and its broad significance for future Medicare reporting and payments. It also frames the article’s focus on changes to familiar quality programs.

2. Look for familiar programs with new names in 2017

   Summarizes the proposed consolidation of existing reporting programs into a single performance framework. It outlines the four main performance categories and the general structure of the new scoring approach.

3. Quality

   Covers the quality performance category and how it relates to earlier reporting structures. It discusses general reporting expectations, measure types, thresholds, and registry or claims-based submission approaches.

4. Advancing Clinical Information (ACI)

   Describes the clinical information category that replaces the earlier electronic reporting incentive framework. It also notes how certain provider settings may be treated under the proposal.

5. Cost or resource use

   Explains the proposed cost-based performance category and the general kinds of measures CMS says may be used. It also notes the category’s broader role in the overall score over time.

6. Clinical practice improvement activities (CPIA)

   Reviews the proposed improvement activities category and the broad types of activities included. It presents the organization of the activity categories without detailing any coding or scoring specifics.

7. Group and provider are now both utilized for MIPS scoring

   Describes how scoring may apply at the individual, group, and tax identification number levels. It also discusses submission flexibility and how performance data may be aggregated.

8. What does this mean for future year incentives?

   Summarizes the article’s discussion of future performance thresholds and potential payment impacts. It also notes the inclusion of additional clinician types in the program.