The Medicare Access and CHIP Reauthorization Act (MACRA) has permanently repealed the Sustainable Growth Rate formula and combined existing quality reporting programs into one new system: the Quality Payment Program (QPP). This system rewards value and outcomes in two ways: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Clinicians may participate in MIPS if they are an eligible clinician type and meet the volume threshold. Clinicians will still be paid according to the Medicare Physician Fee Schedule. However, performance is now measured through the data reported in four areas:

1. Quality. Explore measures
2. Clinical Practice Improvement Activities. Explore measures
3. Promoting Interoperability. Explore measures
4. Cost.  Explore measures
    

[Source: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2018-Quality-Payment-Program-Participation-Infographic.pdf]

Clinicians are assigned a score based on these criteria and are eligible for bonuses or subject to penalties depending on their performance relative to a benchmark performance score.

MACRA and MIPs: Where Are We Now? (10-minute presentation)

In this SCAI/ACC joint session presented at SCAI Scientific Sessions 2018, Dr. Daniel Kolansky reviews the implications of MIPS for the field of interventional cardiology.

CMS Resources:

• About MIPS
• QPP Participation Status Look-up Tool
• Individual vs. Group Participation
• Exceptions
• QPP Webinar Series (including MIPS)

Other Resources:

• AMA – QPP Reporting Basics
• AMA – MIPS Action Plan
• ACC – Outpatient Registry MIPS Measures