The 2018 Medicare Physician Fee Schedule Final Rule (“2018 MPFS” or “Final Rule”) went into effect on January 1. Marked by new additions to the Telehealth codes and the un-bundling of Remote Patient Monitoring code CPT 99091, the 2018 MPFS provides plenty of opportunities for providers to grow their practice through digital medicine. This article outlines key changes to the new Rule.
Have you decided which MACRA participation option your practice will choose in the 2017 transition year? What you choose now (and how you implement) determines your payment adjustment for Medicare Part B billings in 2019 and beyond. In the second blog post of our MACRA series, we talk about the Merit Based Incentive Payment System (MIPS), and what it means for physicians.
The Final MACRA Rule relaxed the more stringent proposed requirements for 2017, so whether you choose to dip your toe in the water or take the full-on MACRA plunge, now is the time to get MACRA-ready and avoid reimbursement penalties. What does MACRA mean for your practice? That's a question we can help answer.
The biggest takeaway from this proposed Rule? Physicians should start planning for this change IMMEDIATELY to best position their practice for financial sustainability. This rule establishes the new Quality Payment Program (QPP) framework, which consists of two new pathways for provider evaluation and payment—the Merit-based Incentive Payment System (MIPS) and participation in Advanced Alternative Payment Models (APMs). The QPP stems from the changes passed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), passed in April of last year. Participation in one of the QPP pathways will form the new basis for the level of payment for services Medicare Part B providers will receive. CMS will begin collecting data beginning in 2017. They will analyze the data for one year, and then use the data to adjust Medicare payments for eligible providers starting January 1, 2019.
The CMS Center for Medicare and Medicaid Innovation (CMMI) has spent the last 6 years testing out a variety of models for value-based care and payment--the Medicare Shared Savings Program (MSSP) and other ACO models, the Bundled Payments for Care Improvement (BPCI) Initiative, the Comprehensive Care for Joint Replacement Model, and various Medicaid and CHIP initiatives. As the Administration doubles down on its commitment to shift payments away from fee-for-service (FFS), it continues to innovate, building programs to align incentives to person-centered, comprehensive, high quality health care. In that vein, in July of this year, CMS will begin taking applications from practices for participation in a new CMMI program: the CPC+ program.