MACRA

Bipartisan Letter Requests Extended Value-Based Payment Incentives

November 4, 2022 - More than 40 House lawmakers have asked congressional leaders to support value-based payment incentives and extend the 5 percent bonus for Alternative Payment Model (APM) participation. In a bipartisan letter sent to House Speaker Nancy Pelosi and Minority Leader Kevin McCarthy, the House members emphasized how the APM incentive payments help...


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Healthcare Orgs Urge Congress to Improve Value-Based Care Participation

by Victoria Bailey

Healthcare groups have called on Congress to extend incentive payments, revise threshold requirements, and expand regulatory waivers to address concerns about the Medicare Access and CHIP...

What Is Value-Based Care, What It Means for Providers?

by Editorial Staff

Value-based care is a form of reimbursement that ties payments for care delivery to the quality of care provided and rewards providers for both efficiency and effectiveness. This form of reimbursement has emerged as an alternative and...

CMS: Automatic Exception for MIPS Eligible Clinicians in 2020

by Jacqueline LaPointe

Individual clinicians who must participate in Medicare’s Merit-Based Incentive Payment System (MIPS) for the 2020 performance period will automatically have the extreme and uncontrollable...

Deadline to Provide Billing Info for Advance APM Bonus Approaches

by Jacqueline LaPointe

UPDATE 11/20/2020: CMS has extended the deadline to update billing information for APM incentive payments to December 13, 2020.  Eligible clinicians who CMS has notified as having missing billing...

CMS Releases Initial Quality Payment Program Results for 2019

by Jacqueline LaPointe

Eligible clinicians overwhelmingly participated in the Quality Payment Program despite facing challenges caused by the COVID-19 pandemic, according to preliminary data from CMS. CMS announced in a...

Most ACOs Worried About Rising Advanced APM Thresholds Next Year

by Jacqueline LaPointe

A new survey confirms a growing concern among accountable care organizations (ACOs) – most ACOs are unlikely to meet rising participation thresholds for MACRA’s Advanced Alternative Payment...

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

by Jacqueline LaPointe

Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received...

Lawmakers Propose Changes to MACRA to Boost ACO, APM Participation

by Jacqueline LaPointe

A bipartisan bill introduced late last week aims to increase alternative payment model (APM) participation by making “commonsense changes” to the Medicare Access and CHIP Reauthorization...

Clinicians to Earn MIPS Credit for Joining COVID-19 Clinical Trial

by Jacqueline LaPointe

Clinicians earning value-based reimbursement through the Merit-Based Incentive Payment System (MIPS) will be able to earn credit for participating in and reporting information on COVID-19 clinical...

Advanced Alternative Payment Model Participation Rose in 2018

by Jacqueline LaPointe

Over 84,200 more eligible clinicians sufficiently participated in one of the Quality Payment Program’s Advanced Alternative Payment Models (APMs) in 2018 compared to the previous year, according...

CMS Says Clinicians to Receive Advanced APM Bonus Payments Soon

by Jacqueline LaPointe

In a fact sheet created on Sept. 27, CMS announced that Advanced Alternative Payment Model (APM) bonus payments for participation in an approved model in 2017 will be going out to qualifying clinicians...

Providers Ask CMS Where Their 2019 Advanced APM Bonus Is

by Jacqueline LaPointe

More than 90,000 clinicians are still waiting on the 2019 Advanced Alternative Payment Model (APM) bonus payment for their participation in 2017 and nine industry groups are demanding payment from...

Unpacking Proposed Merit-Based Incentive Payment System Changes

by Jacqueline LaPointe

CMS is planning to overhaul reporting for the Merit-Based Incentive Payment System (MIPS) in order to make the pay-for-performance program less burdensome and more meaningful to providers, according a...

Advanced APM Participation Almost Doubled from 2017 to 2018

by Jacqueline LaPointe

Advanced Alternative Payment Model (APM) participation in the Quality Payment Program (QPP) nearly doubled from 2017 to 2018, increasing from 99,076 to 183,306 clinicians, CMS recently reported in an...

AMA Seeks Alternative Payment Models for Vulnerable Populations

by Jacqueline LaPointe

In an effort to reduce healthcare disparities, the American Medical Association (AMA) recently vowed to support the creation of new alternative payment models that specifically address the outcomes of...

As MACRA Implementation Turns 2, Industry Leaders Call for Change

by Jacqueline LaPointe

For the past two years, MACRA has been shifting providers away from fee-for-service to value. But industry leaders still have reservations about MACRA implementation and the law’s value-based...

MIPS Participation Reached 95% in 2017, Exceeding CMS Goals

by Jacqueline LaPointe

Ninety-five percent of eligible clinicians avoided a negative payment adjustment through Merit-Based Incentive Payment System (MIPS) participation in 2017, of which 93 percent earned a positive...

AMGA: Full MACRA Implementation Needed to Advance Value-Based Care

by Jacqueline LaPointe

AMGA is urging Congress to enforce MACRA implementation as policymakers intended by no longer excluding providers from the Merit-Based Payment Incentive Program (MIPS). “MIPS was designed as a...