Almost a full year has passed since the Centers for Medicare & Medicaid Services (CMS) deemed 2017 as the transitional year for independent physicians to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA has two available tracks: Alternative Payment Models (APMs) and a Merit-Based Incentive Payment System (MIPS). At this point, most physicians should at the very least, be aware of MIPS, but for those still unfamiliar: MIPS replaces the previous years’ Medicare reimbursement system and existing value-based care programs (physician quality reporting system or PQRS, meaningful use and the value-based modifier) with a new pay-for-performance program. While we can expect to see ongoing shifts in the legislation, the new program is focused on quality, value and accountability and emphasizes quality of care over number of patients seen. Regardless of MIPS’s original intent to improve health care for both patients and physicians, the new legislation can result in negative Medicare payment adjustments if not followed correctly.

• Data accuracy is key—With MACRA, your performance is compared with similar groups across the country. Therefore, the data you enter needs to be accurate to ensure an adequate description of your practice is reported.
• Meet your performance marker— It is important for physicians to review quality measure benchmarks and understand what is required for above-average performance. To do this, put practice strategies and clinical workflows in place to help meet the criteria.
• Keep up with your ICD-10—The 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) is and will continue to be a crucial part in the transition as we move toward quality reporting. Accuracy on the highest level such as ICD-10 needs to be maintained and up-to-date.

Overall, physicians must understand the impact of MIPS, stay ahead of the changes and adjust their practice accordingly. Just like with any new legislation, there is bound to be natural friction with the transition to MIPS, but the right technology can ease the process and help you succeed.

To learn more about the current timeline of MIPS and requirements, visit CMS.gov.

Julie C. Servoss, MD, is the medical director of gastroenterology at Modernizing Medicine in Boynton Beach, Florida. Write her at julie.servoss@modernizingmedicine.com.

The advice and opinions expressed in this column are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion.