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MIPS and MACRA — The Time is Now!

Starting in 2017, physicians must make an important decision each year—one that will affect Medicare reimbursements.

The new Medicare Quality Payment Program, which includes the Merit Based Incentive Payment System (MIPS), has an implementation date of Jan. 1, 2019, but physicians must take action starting in 2017 to avoid payment reductions or have a chance to receive payment incentives in 2019 of up to 4 percent.

“Due to the advocacy efforts of the American Medical Association, the Kentucky Medical Association and physicians across the country, Medicare has made a number of positive changes to the final regulations for the Medicare Accountability and CHIP Reauthorization Act,” said Lindy Lady, KMA’s Medical Business Advocacy manager.

Lady will explain these changes impacting reimbursement for physicians who participate in Medicare in a fast-paced one-hour presentation at the KMA Physicians’ Day at the Capitol Feb. 22.

“MIPS and MACRA – The Time is Now” will include discussion of “several steps physicians can take to avoid a penalty and increase their positive payment adjustments in 2019,” Lady said.

“If physicians submit at least one quality measure for one patient or one practice improvement activity measure in 2017, they will avoid a penalty in 2019,” said Lady.

An example of a quality measure that may be reported by any physician specialty is tobacco intervention and cessation counseling. If physicians integrate prevention and treatment interventions, including tobacco use screening and cessation for patients with co-occurring conditions, they may get credit under the practice improvement category.

If physicians don’t take any action, they will receive a negative 4 percent payment adjustment.

“If Medicare patients make up 25 percent of their practice—over 12 months, that’s quite a bit of money,” Lady said.

Another measurement that will influence payment reimbursement is physician ratings on the Physician Compare website at Patients will rate their experiences on a scale of 1 to 5 on such things as timely care and medication instructions.

“Physicians should monitor this website to protect their reputation against misinformation and mistakes,” Lady said.

Lady will give her presentation at the Thomas D. Clark Center for Kentucky History from 12:15 to 1:15 p.m.; lunch is included. Participants will earn one CME credit hour. Visit to register.


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