(Last Updated On: September 5, 2017)

From: Ted Itzkowitz, President
Date: June 1, 2016

As you probably already know, there are some big changes coming in the way CMS and other insurance companies are going to pay physicians for the services they provide to their patients. All of this came about through a bill passed by Congress known as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule and replaces it with a new Merit-based Incentive Payment System (MIPS).

Essentially, CMS is going to compare all the doctors in a certain area to determine which ones provide the best outcomes for the least cost for a particular disease and pay those doctors more than the standard allowable than other doctors. In turn, those doctors who have the poorest outcomes and/or the highest costs will be paid less than the standard allowable.

There are a number of “consultants” who claim to know everything about MACRA/MIPS and there are lots of rumors flying around. The simple fact is CMS has not yet worked out all the details, known as the final rule, but, the broad outlines are clear. STI has a number of people deeply involved in what’s going on at CMS as well as following various opinion makers who may be able to influence the final rules as they come out.

To that end, STI is going to host a series of webinars beginning in June to cover what is currently known about how MACRA/MIPS will work and what you have to do to be prepared for it. The first seminar will be on overview of the program. Additional webinars will cover some of the specifics in greater detail.

As a preview to the webinars I can tell you a few things we know for sure. First, it’s important to continue PQRS and Meaningful Use attestation in 2016 as they will affect your 2018 reimbursements from CMS. And further, PQRS and Meaningful Use are not going away. The names are changing but, together they make up a significant part (75%) of the MIPS program. Second, one of the measurements that will positively affect your reimbursement from CMS is having a certified EMR system up and running as of January 1, 2017. If you are interested in STI’s ChartMaker EMR please contact us via phone or on the website.

So please watch our website for information about the webinars and sign up for them. The small investment of your time now will pay you dividends in the future.

And finally, it’s important to remember this is a process. Every physician in the country will have to evolve. It’s not overwhelmingly difficult, it’s just different. The sooner you get good information about it the easier it will be to adjust your processes in preparation for the changes. STI is here to help make those adjustments easier.

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