Home Forums Discussions General Discussion MIPS/MACRA

Howdy to all.

The more I read about MIPS and the more I think about it the less inclined I feel to participate. As a solo family doc Medicare is only about 25% of my practice. Anyone else thinking about skipping MIPS for now?

John

Yes,skipping MIPS, CPC+, MACRA. Hoping Tom Price may tweak some of these issues.
http://tomprice.house.gov/press-rel...caucus-urge-administration-address-macra

Tom Price voted for MACRA.

I thought Tom voted against everything. I know the AMA (which is useless) is pushing for him. I remember putting a link to a town hall meeting. I believe you.

_________________

I don't do any of the government-pushed garbage. Of course, it doesn't affect MaineCare as much.

What they should do is a complete health screening on all of Congress. Cholesterol, blood pressure, blood sugars, etc. See if they would fit the profile of "good outcomes." Besides the sheer time wasting of this and the lack of autonomy, we simply can't get the patients to comply. I have way less diabetics than FP and IM. Maybe 10. But, none of them, NONE, have ever had a decent HbA1C. Maybe they need to change the reference values. I am serious. Not one has ever had a normal HbA1C.

Government just needs to stay out of healthcare. And, the latest is the opioid crisis. Yeah, I am sure that we have contributed to some long-term addiction. But, instead of healthcare changes to help those addicted and doing more at the level of the supply, they impose crazy regulations on prescribers. I'm pretty sure checking the PMP will stop the Heroin/Fentanyl combination drug. I checked the other day, and it said three of my patients were on heroin. Wouldn't have even known. Thank God for checking the PMP.

So, here is the story of why the heroin epidemic is out of control. And, I took care of this patient since birth. Never prescribed pain meds with the exception of may one or two times for acute pain. So, she is now 19 and in the back of a car with her "friends." Overdoses and they throw her out in a snowbank. Cops give her Narcan, and take her to hospital. They observe, offer a mental hospital, but she is not suicidal, so hey, send her home. She is cured. Not even a social worker. Not even a f/u appt, which I know she would have missed. But, I guess that would be my fault for not writing an ICD-10 code on a script.

Jon,

Yes but....

http://medicaleconomics.modernmedic...-about-hhs-secretary-designate-tom-price

attention page 7

I am for Tom Price, but it does sound like he is talking out of both sides of his mouth there.

medicare is about a 1/3 of my practice I intend to skip MIPS MACRA figure if I get the maximum penalty ? 7% that is about a 3% cut to my income, would rather stay an extra 20 minutes and work another patient into the day than do those exercises of near futility

We are in agreement about skipping MIPS/MACRA. The requirements are ridiculous and we don't have the staff/time/energy/patience, etc. to comply with them.
I fail to see how any of what Medicare is asking us to do is going to HELP the aging population with their actual care.
(Ugh.....pencil pushers with too much time on their hands...SMH)

If I can chime in here, for 2017 there is a "testing" option for MIPS that states that if you just do ONE measure for any length of time (even one day), then you will not get a penalty for the first year. For those of you that are considering not doing MIPS at all, this might be a good option for you. Why take the 4% penalty right off the bat when you can do a minimal amount of work and avoid it?

good chime in mark although it does stink of dancing with the devil to some degree
may look into it
any built in function in AC to turn it on for a day?

At the most recent meeting of the AC Advisory Board, the presentation from the AC staff was much along the lines of what Mark is saying above. Going "all in" to try to get a significant bonus/incentive payment may be very difficult with no promise of success, and therefore is not worth the effort. On the other hand, avoiding a penalty (or getting a small increase) is likely possible with relatively minimal effort.
The latter will not require anything like a year's worth of participation, so we can safely wait a few months to learn and decide how to meet those minimal criteria as the year goes on.

And Jim, I guess you are much more of an optimist about Dr. Price than I am.

There are a few things you can do. The easiest is to attest to one Improvement Activity. Its an attestation (just a yes or no answer to a question), there are ALOT to choose from (92 different measures), and most of them providers seem to be doing anyway outside of your practice (annual registration to a drug monitoring program, doing depression screenings on patients, Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare).

Check out this site for the Improvement Activities: https://qpp.cms.gov/measures/ia

Now you can do some of the MU measures, but those you have to do for 90 days, and the point is to avoid the penalty and make it as easy as possible.

Quick Shameless Plug: I'll be doing a MIPS training class at the Amazing Academy training classes this year. First one is in Ft Lauderdale in February (who doesn't love Florida in the winter). Here is the link: http://amazingcharts.com/support/ehr-training/amazing-academy-ft-lauderdale/

Thanks for everyone thoughts on MIPS--Mark D's suggestion for a minimal "testing" option is especially appreciated.

Jon,

I suppose so.

Another good read on MACRA just came across today on twitter.

http://buff.ly/2i9eBpK

I am not participating in MIPS and plan to fully ignore MACRA, taking the maximum penalty. Wellness exams and CCM will more than make up for any potential penalties.

Very small medicare practice and i already got a letter for 1% decline in pay from last year...so be it...don't care. ..the govt can kiss my you know whaat