MACRA and the QPP:
How InterSystems Products Can Help
What is MACRA?
MACRA replaced the Sustainable Growth Rate formula and simplified the incentive programs associated with the Medicare Physician Fee schedule. CMS named the new payment system under MACRA the Quality Payment Program (QPP), offering providers two paths to earn value-based payments.
Who is Eligible?
Clinicians who bill professional services under Medicare Part B (Physician Services) are eligible.
- Physicians, physician assistants (PAs), nurse practitioners (NPs), clinical nurse specialists, certified registered nurse anesthetists, physical therapists, occupational therapists, qualified speech-language pathologists, qualified audiologists, clinical psychologists, registered dietitian or nutrition professionals, and groups that bill under Part B
- Excludes physicians in practice settings that do not meet certain billing or encounter thresholds for Part B Medicare services
What are Providers’ Options for Participation
There are two tracks for participation under the QPP
- Merit-based Incentive Payment System (MIPS)
- Alternative Payment Models which include Advanced Alternative Payment Models (A-APMs)
How Will You Know if You Need to Participate in MIPS?
If you are eligible and DO NOTHING in 2020, you will receive a 9% reduction in your Medicare payments in 2022.
How Can InterSystems Products Help You Meet the Criteria Under the QPP?
The best product for you depends on which track you are in, MIPS or A-APMs. For details on the two programs and how we help you support them, see page two of our MACRA fact sheet.