If you belong to the healthcare industry, chances are you’ve been hearing a lot of MIPS and the Advancing Care Information program. It feels like as soon as you get your grips with one legislative change they are ushering in another. MIPS Advancing Care Information program is the proposed replacement for MACRA’s Meaningful Use program.
The proposal for Advancing Care Information is designed to simplify requirements, support patient care, and be flexible to meet the needs of physician practices. The proposal includes an emphasis on measures to reduce the burden and improve patient engagement and connectivity.
For the time being these new changes will only affect eligible providers and not hospitals. So what exactly do these providers need to know about the Advancing Care Information program?
Three into One
The Advancing Care Information program aims to consolidate three existing programs under one large roof. The Physician Quality Reporting System (PQRS), the Value-Based Modifier Program (VBMP) and Meaningful Use will be part of Advancing Care Information.
Reimbursement
The way clinics will be paid will now be based on four performance categories:
- Quality – Providers can choose six measures to report on from a range of options that will factor both specialty and practice.
- Advance Caring Information – Eligible providers will now have greater flexibility in regards to which measures they report. Providers will have the choice to customize measures with a stronger focus on interoperability and information exchange.
- Clinical Practice Improvement Activities – Clinics will be rewarded for making improvements in certain activities.
- Cost – Scores are calculated based on Medicare claims rather than specific reporting requirements.
No Reporting Thresholds
One of the least liked clauses of Meaningful Use was the reporting thresholds providers were required to meet. The requirements were written in stone, and if a provider was unable to meet the threshold by just one, that medical practice would fail to attest to Meaningful Use.
The new plan proposes to get rid of the reporting threshold. Though low-performance scores will still affect a clinician’s score, it won’t result in immediate failure of the entire program.
A Choice
For eligible providers, there is a choice if they chose not to participate in the MIPS program. The alternatives are a different path toward value-based care – alternative payment models (APMs).
APM participants receive payment for delivering professional services and are also eligible for an incentive payment equal to five percent of the estimated aggregate payment amounts for such covered professional services under this part for the preceding year.
Going forward it should be clear that though Meaningful Use has been curbed in some instances, it is far from dead. AIC provides an alternative for some of the stricter regulations of Meaningful Use. Yet these are still in the proposal stage and what the outcome will be might be very different. Watch this space.
