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Response on MACRA

The author has provided a brief description of the MACRA, the MIPS and the APMs including a history of their establishment. It has been noted that the MACRA was established in 2015 to make changes to the healthcare payment system (CMS, 2018). However, the date of establishment of the APMs and the MIPS was not given. The essay fully describes some of the anticipated benefits following the implementation of the MACRA.

For instance, it is projected that the MACRA will relieve the clinicians’ burden besides allowing them to select activities and payment measures that are meaningful to their practice (The Coding Institute, 2016). The author has accurately highlighted the key measures which the clinicians will present to the CMS to best reflect their practice. It has been clarified that these measures must reflect the outcome of care, specialty measure set, information exchange and patient engagement.

The author has also indicated the process through which the clinicians will earn a performance-based payment adjustment besides clarifying that clinicians involved in care transformation will take part in advanced APMs. This will enable them to earn a Medicare incentive for being part of the innovative payment model (CMS, 2018).

The information contained in the essay is highly relevant to practitioners since it indicates the inclusion and exclusion criteria for the MIPS. The author noted that providers who take part in the APMs are not eligible for the MIPS. Moreover, clinicians will be exempted from the MIPS if they bill less than $30,000 in Medicare beneficiaries annually (The Coding Institute, 2016). To ensure payments are done accurately, the CMS, as highlighted in the essay, will carry out low-volume status determinations before as well as during the performance period using claims data.

 

 

Bibliography:

CMS. 2018, APMs Overview, viewed on March 14, 2018 <https://qpp.cms.gov/apms/overview>

The Coding Institute, 2016, Guidebook to Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), The Coding Institute, New York.

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