This Week – October 29, 2016

This Week in Washington, D.C.

From ACG National Affairs Committee Chair, Whitfield L. Knapple, MD, FACG


MACRA… MIPS… QPs… APMs… QCDRs… ACOs… Why does Washington D.C. love acronyms and complicated payment systems?  ACG hopes to keep this simple.  ACG has reviewed the law and continues to review the final regulation that implements MACRA.  We compiled a detailed overview in plain English that seeks to make some sense out of this alphabet soup.  In the upcoming days, ACG will continue to roll out a “MACRA Tidbit for the Week” and other educational guidance developed by ACG’s National Affairs Committee.

From ACG Practice Management Committee Chair, Michael S. Morelli, MD, FACG

Physician Compare Preview Period- Ends November 11

CMS allows 30 days to let ACG members preview your 2015 Medicare quality reporting performance before the data is publicly reported on Physician Compare (late 2016).

The 30-day preview period ends on November 11, 2016.

You can access the secured preview site now through the PQRS-Provider Quality Information Portal. Learn how to preview your performance scores using the Guide to Physician Compare Preview Period.

What is the Physician Compare website?  

Launched in December of 2010, the Physician Compare website is required by the Patient Protection and Affordable Care Act (ACA). The website includes information about physicians and other health care professionals who satisfactorily participate in CMS quality programs (i.e. PQRS and Meaningful Use).  It is designed to help Medicare beneficiaries search and review physicians in their area, using Medicare quality reporting data as the benchmarks.  ACG has been active on your behalf urging Medicare to ensure that the data about you is indeed accurate prior to being released publicly.  Be sure to review your data prior to November 11th.


The Basics for 2017

CMS views CY 2017 as a transition year to ease ACG members into MIPS.  In September of 2016, CMS eased earlier reporting requirements, so that even if you make some sort of effort in quality reporting in CY 2017, you will not receive a cut in 2019.  CMS confirmed this policy when releasing the final MACRA regulation earlier this month.  Here’s the skinny:

  1. If you don’t submit any 2017 data by March 2018, then you will receive a 4% payment cut beginning January 2019.
  2. If you submit a minimal amount of 2017 data, you can avoid a payment cut in 2019.  For example, just submitting one quality measure or one improvement activity will do.
  3. If you submit a continuous 90-days’ worth of 2017 data, you will avoid the payment cut and potentially get a bonus payment in 2019. (October 2, 2017 is the important date here).
  4. If you submit a full year’s worth of 2017 data, you will avoid the payment cut and may earn a “moderate” payment bonus in 2019.

Please note that you will receive the same credit whether you submit 90 days’ worth of data, or the full calendar year.  What drives your bonus is the amount of data you provide, your performance, as well as your performance when compared to others.