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EMR/EHR Software

Advantages of the Medicare Access and CHIP Reauthorization Act (MACRA)

Effective 2017 through 2019

The Quality Payment Program (QPP) introduced by MACRA offers two tracks for healthcare providers to choose from:

1.Merit-based Incentive Payment System (MIPS)

2.Advanced Alternative Payment Models (APMs)

The Quality Payment Program enhances Medicare by emphasizing care quality and prioritizing what matters most—improving patient health. It provides new tools, models, and resources to help you deliver the highest quality care to your patients. Depending on your practice size, specialty, location, or patient population, you can select the participation track that suits you best.

Merit-based Incentive Payment System (MIPS)

MIPS consolidates existing quality programs—such as the Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use—into a single, budget-neutral program. Providers are scored based on four key performance categories:

  • Quality
  • Resource Use
  • Clinical Practice Improvement Activities
  • Advancing Care Information

Payment adjustments are assigned accordingly, allowing providers to be rewarded for their efforts in enhancing care quality.

Advanced Alternative Payment Models (APMs)

APMs incentivize providers with a 5% annual bonus from 2019 to 2024, provided they maintain a significant share of their Medicare revenue and/or patients in contracts that involve two-sided payment risk (e.g., the Next Generation ACO program).

MIPS Reporting Requirements

Nearly 90% of eligible clinicians are expected to report under the MIPS track for payment in 2019. Those qualifying under MIPS must fulfill reporting requirements across the four performance categories outlined above, ensuring that all providers have the opportunity to enhance their practices while improving patient care.