Want To Stay Independent Under MACRA?

Unlock Your Patient Data To Improve Quality Today!

Starting in 2017, your clinicians will be evaluated by Medicare through a new system mandated under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) called the “Quality Payment Program”. Under this system, your practice has two options:

Advanced Alternative Payment Models (APMs)

Include MSSP ACOs in Tracks 2 & 3 and Next Generation ACOs

The Merit-Based Incentive Payment Systems (MIPS)

Everybody else will be subject to MIPS

PQRS 2016 – Get Ready For MACRA

Under MIPS, a large (up to 16% in 2017 and growing each year thereafter) of your clinicians’ Medicare Part B reimbursement will depend on your performance. In 2017, clinical quality makes up 50% of your clinicians’ performance score. Don’t wait till the end of the year to measure and report … Leverage the last year of PQRS to ensure that your practice maximizes Medicare reimbursement… Clinigence offers PQRS 2016 reporting that ensures your practice will be ready for MIPS or any MACRA model for years to come!

Leverage Fee-For-Service Opportunities

Many activities promoted under value-based payment are also reimbursable under current fee-for-service (FFS) models. Since value-based models, such as shared savings, often offer only deferred reimbursement, you may find it especially beneficial to leverage any opportunity to increase revenue in the short-term while building your capacity to take on risk and deliver value in the future. Among these opportunities:

  • Annual Wellness Visits (AWVs)

  • Chronic Care Management (CCM)

  • Closing Gaps in Care

  • Comprehensive Primary Care Plus (CPC+)

  • Preventing Network “Leakage” – making sure patients stay within your practice or IPA for all available services

In all of the above, Clinigence identifies and intelligently stratifies your patients in need of service – ensuring they get better care while you secure the associated add-on revenue.

Advanced Alternative Payment Models (APMs)

If you are already participating in a Track 2 or 3 Medicare Shared Savings (MSSP) ACO or a Next Generation ACO, or if you are considering participation in either of these models in 2017, follow this link to read about our solutions for ACOs and Risk-based Delivery Organizations.

The Merit-Based Incentive Payment System (MIPS)

The Merit-based Incentive Payment System (MIPS) combines the Physician Quality Reporting System (PQRS), the Value-based Payment Modifier, and the Medicare Electronic Health Record (EHR) incentive program into a single program. Your clinicians’  2017 performance can impact your Medicare Part B reimbursement by up to 16% and growing each year after that.  Your MIPS score will be based on your performance in 4 areas:

  • Quality (50% in 2017)

  • Resource Use (10%)

  • Clinical Practice Improvement (15%)

  • Meaningful Use of Certified EHR Technology (25%)

Read more about how Clinigence can help your practice boost your MIPS score and increase your Medicare reimbursement under MIPS.

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