It is easy to be turned-off by the entire MIPS/MACRA program, and to decide not to participate. You can not only skip all of the hoops of participation, but you also don't need to waste time learning how the program works or any of the minutiae of the program requirements. I think that would be a mistake though because you can very easily avoid a cut to your Medicare income in 2019 with a minimal amount of effort.

First, a brief explanation. MIPS/MACRA is designed to simplify the CMS incentive/punishment programs. Beginning in 2017, there is no more MU, PQRS, eRx, or value based modifiers... they are all combined into MIPS. The program, its components, and the program requirements are still voluminous and complex. A key point for 2017 is that our activities this year determine a pay cut or raise between -4% and +4% on our Medicare payments for 2019. Without going into detail here, getting any bonus will be difficult. Even if you participate for all 365 days of 2017, in all the components of the program, there is NO guarantee that you will get a 4% bonus. Even with year-long, perfect participation, a much smaller bonus is likely. Medicare states this very clearly. What IS guaranteed is that if you do NOTHING, then you will have a 4% cut in 2019.

The good news is that you can break even and avoid that 4% cut with a minimal amount of work. CMS has decided to offer a "test" path for 2017. Participation in the test path will not get you any bonus but it will avoid any cut. Participation involves a minimal amount of work. Theoretically, submitting a single Medicare claim with the appropriate added codes will be regarded as successful test participation, and you avoid the 4% penalty. For safety, you may choose to do more than one claim, but the requirements are minimal. How do you know what codes to pick? I will be happy to discuss that in future posts, but there are many easy choices.

AC is doing an excellent job of trying to organize this information and you will be hearing more about this as the year goes on. That is especially important if you plan to participate more fully than what I describe here.

For more details on the test path and how to navigate it, AC has prepared an excellent summary which you will find here. It contains a large amount of information condensed into a small space, but I would suggest that you focus on the "Quality Measures" section, which they mark as the "easiest option" and then use the "claims" method of submission (which is quick, easy and free).

So for now, you need do absolutely nothing. Simply resolve that before the end of the year, you will spend a few minutes reading here which codes will save you the 4% cut, and then submit a few claims with the added codes. If you object to this program on moral or political grounds, then that of course is your choice. To lose 4% because it is "too much work" or "too hard to figure out"... that, I think, would be a mistake.


Jon
GI
Baltimore

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