Incorporating Quality Reporting/ MACRA into Your Practice

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Incorporating Quality Reporting/ MACRA into Your Practice

Business of Medicine
Author Credentials 

Lance Manning, MD
Ear, Nose, and Throat Centers of the Ozarks
Springdale, AR

Module Summary

On April 16, 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) became law. It replaced the SGR and created what CMS terms the Quality Payment Program. This is a transition from fee-for-service to quality-based payment by implementing two payment pathways for clinicians using the new Merit-based Incentive Payment System (MIPS) or an eligible Alternative Payment Models (APMs). This module outlines an overview of MACRA, its respective component parts, and describes how to incorporate this into an Otolaryngology practice.

Module Learning Objectives 

After completing this module, the physician will be able to:

  1. Follow the transition from SGR to the new Medicare Access and CHIP Reauthorization Act (MACRA).
  2. Summarize an overview of MACRA as it pertains to Otolaryngology and describe components quality measures of MACRA.
  3. Describe the Merit-based Incentive Payment System and the Alternative Payment Model program.
  4. Discuss how quality-based payments programs will affect payment over the next few years.
  5. Describe how to potentially earn incentive payments and avoid payment reductions. 
  6. Delineate between a variety of organizations, vehicles, and tools for quality reporting. 
  7. Create strategies to implement quality measures into your workflow.
Overview
  1. The transition from SGR to the new Medicare Access and CHIP Reauthorization Act (MACRA)
  2. Overview of MACRA as it pertains to Otolaryngology and describe components quality measures of MACRA
  3. Describe the Merit-based Incentive Payment System and the Alternative Payment Model program
    • MIPS Overview
      • Quality Measures Category
      • Advancing Care Information Category
      • Improvement Activities Category
      • Cost Performance Category
    • APMs Overview
  4. Discuss how quality-based payments programs will affect payment over the coming years
  5. Describe how to potentially earn incentive payments and avoid payment reductions
  6. Delineate between a variety of organizations, vehicles, and tools for quality reporting 
  7. Create strategies to implement quality measures into your workflow 
Review Questions
  1. In the MACRA transition from traditional Medicare fee-for-service payment to quality-based payment, what are the two major categories for physician reporting?
  2. What are the four components that make up the 100 point MIPS performance score?
  3. Describe the positive and negative payment adjustment that physicians can receive under MACRA through year 2020.
  4. What is the difference between an APM as it pertains to MIPS and the Advanced APM alternative pathway?
  5. How many quality measures are required for full MIPS reporting for this year?
  6. What are the major categories of quality measures and how many are required from each major quality category for full reporting?
  7. Name three different organizations under which a physician can report MIPS.
  8. Name two quality measures related to sinusitis, two measures related to otitis media, and two quality measures related to imaging that can be easily performed in your workflow to meet Quality reporting requirements.
Resources 

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  1. Annual Meeting Webcast (AMW):

AMA Rescources:

ACS Rescources:

CMS Resources: