[MACRA Logo_outlines_3.5.2016]

AAFP Tools and Resources:

2018 Updates to the Quality Payment Program

Making Sense of MACRA: Understanding Your Pathway

Prepare for Quality Payment Program (QPP)

Pick Your Pace for the 2017 Transition Year

Technical Assistance Programs to Transition to the Quality Payment Program (QPP)

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Important Update: 10/17/2016

The Centers for Medicare and Medicaid Services (CMS) released the final rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA). The regulation finalizes all provisions of the law.

The final rule incorporates numerous AAFP recommendations, especially those aimed at assisting solo/small practices.  For additional information:

Click HERE for the AAFP News article
Click HERE for a statement from the AAFP

The AAFP continues to work to develop tools and resources that will assist family physicians, and we will share those with you as they become available.

MACRA in a Minute: Watch the Video HERE


Additional information about the proposed rule, released April 27, 2016:
Courtesy of Dr. Sarah Woolsey, UAFP Past-President

  • Info about proposed MACRA Rule: Click HERE
  • Five important facts about MACRA: Click HERE

Payment reform is coming, and your Academy is here to lend a hand. Let us help you prepare today so we can guide you through the transition tomorrow.  Resources also available at aafp.org/MACRAReady

Summary:

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently repeals the flawed sustainable growth rate (SGR) which would have cut Medicare reimbursements by 21 percent.  It extends the children’s health insurance program (CHIP) by two years, and most importantly, it sets up a new, two-track Medicare physician payments system that emphasizes value-based payment models.

Physicians will enter one of two payment tracks:

  1. Merit-Based Incentive Payment System (MIPS)
    1. Consolidates three existing programs: Meaningful Use of EHR, physician quality reporting system (PQRS), and value-based payment modifier (VBPM) into the
    2. New System: Consolidation of Quality, Resource Use, EHR, Clinical Practice Improvement Activities (CPIA), plus an additional performance category to generate a composite score
  2. Alternative Payment Models (APMs)
    1. Incentive payments will be available to qualified professionals who practice in a qualified and eligible APM.
      1. CMS Accountable Care Organizations (ACOs)
      2. Medical Home Models which can be be expanded under the Center for Medicare and Medicaid Innovation (CMMI)
      3. Demonstration required by federal law

***A new Physician Payment Timeline has been defined: please see this BROCHURE for details, found on page 2***


 

Other Highlights:

  1. Under MIPS, physicians who are part of  “certified” PCMH automatically receive the highest score for the CPIA category. “Certified” has not yet been defined in law.
  2. The first year for MIPS is 2019. The AAFP anticipates that performance in 2017 will determine the threshold for the first year of MIPS.
  3. Qualifying APM participants receive an annual lump-sum bonus of 5% upon meeting certain eligibility requirements.
  4. Beginning in 2026, APM participants will receive a 0.75% annual update to their Medicare physician fee schedule.
  5. There are many unknown details in MACRA that will be clarified during the rule-making process. CMS released its proposed rule on April 27 (access the rule HERE) and the final rule is anticipated in fall 2016.