The American Gastroenterological Association analyzed the Medicare Access and CHIP Reauthorization Act final rule and what it will mean for gastroenterologists.
Here is what you need to know.
1. The most significant changes relate to the Quality Payment Program which is replacing the Physician Quality Reporting System, EHR Meaningful Use and the Value-based Payment Modifier programs.
2. CMS developed specialty-specific measure to make it easier for physicians to find applicable ones for their specialty.
3. To fully participate in quality performance, physicians can either report on:
- Six quality measures the physician selects among available measures, including one outcome based measure; or
- Six measures in a specialty-specific measure, including one outcomes measure, for a minimum of a continuous 90-day period.
If neither of those are applicable, a physician must report one high-priority measure relating to either: appropriate use, patient safety, efficiency, patient experience or care coordination.
In 2018, CMS may require the reporting of a cross-cutting measure. It has been suspended for 2017.
4. Next year will be a transition year, and the reporting requirements have been reduced.
In 2017, a physician can pick between four options. They are:
- Reporting to the Merit-based Incentive Payment System for 90 days, or "ideally the full year."
- Report to MIPS for at least 90 days, and less than the full year, but include "one quality measure, more than one improvement activity or more than the required measures in the advancing care information performance category."
- Report one measure in quality performance, one activity in improvement activities or report the required advancing care information performance category.
- Participate in Advanced Alternate Payment Models. If a physician receives a sufficient portion of Medicare payments or sees a "sufficient" portion of Medicare patients through APM, they qualify for a 5 percent incentive bonus through 2019.
If a physician does not report at least one measure or activity, they will receive four full negative payments.
5. "To meet performance thresholds for 2017, GI physicians need to submit one out of six quality measures — more measures are required for groups that submit through the CMS web interface; attest to at least one improvement activity; and report on the required measures in advancing care information."
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