Under the Medicare Access and CHIP Reauthorization Act, an estimated 340,000 practices, mostly composed of practices between one member and 24 members, may endure penalties in 2019, according to Medscape.
Here are seven insights:
1. Medicare will provide an estimated 412,000 physicians and clinicians bonuses as high as 4 percent in 2019.
2. Critiques of MACRA say programs should give all physicians, no matter the practice size, the same opportunity for bonuses.
3. CMS' implemented MACRA to shift reimbursement from a fee-for-service model to a pay-for-performance model.
4. Physicians can choose two payment models under MACRA — Merit-Based Incentive Payment System or alternative payment models.
5. CMS aligns meaningful use of electronic health records, the Physician Quality Reporting System and the Value-Based Payment Modifier under MIPS.Physicians participating in MIPS can receive bonuses and penalties up to 4 percent in 2019. This number will increase to 5 percent in 2020, 7 percent in 2021 and 9 percent in 2022.
6. As part of APMs, CMS estimates between 31,000 clinicians and 90,000 clinicians will qualify for bonuses between $146 million and $429 million. CMS maintains only those APMs deemed "advanced" will qualify for such payments.
7. Physicians who have a substantially low volume of Medicare patients and revenues and physicians in ineligible specialties do not have to participate in MIPS or APMs. CMS estimated between 524,000 clinicians and 583,000 clinicians will be exempted from MIPS in performance year 2017 and in payment year 2019.
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