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Wound Care Articles and Insights
January 27, 2017

CMS QUALITY PAYMENT PROGRAM

Melissa Bailey

With the start of 2017, MACRA is now in full swing.  For those of you planning on participating in the Merit-Based Incentive Payment System, please note the following five different options:

 

  1. Don’t participate – If you don’t send in any 2017 data, then you will receive a negative 4% payment adjustment
  2. Test the Quality Payment Program – Testing the program by submitting a minimum amount of 2017 data to Medicare (for example, one quality measure or one improvement activity at any point in 2017), allows you to avoid a downward payment adjustment. This option is designed to ensure that your system is working and that your practice is prepared for broader participation in 2018 and 2019 as you learn more.
  3. 3. Participate for part of the calendar year – You may choose to submit Quality Payment Program information for a reduced number of days (Any consecutive 90 day period). Therefore, your first performance period could begin later than January 1, 2017, and your practice could still qualify for a small positive payment adjustment.
  4. Participate for the full calendar year – For practices that are ready to go on January 1, 2017, you may choose to submit Quality Payment Program information for a full calendar year. By submitting the full year of 2017 data to Medicare, you may earn a modest positive payment adjustment.
  5. Participate in an Advanced Alternative Payment Model – Instead of reporting quality data and other information; the law allows clinicians and practices to take part in the QPP by joining an Advanced APM, such as a Medicare Shared Savings Track 2 or 3 in 2017. If you receive enough of your Medicare payments or see enough of your Medicare patients through the Advanced APM Model in 2017, then you would qualify for a 5% incentive payment in 2019.

The preferred option, for maximum incentive opportunities, is participation for a full calendar year.  Clinicians, who are fully committed to the MACRA Quality Payment Program, will find themselves ahead of the curve as penalties in future years continue to escalate.

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