MACRA Rule Changes for 2018 Data

In the beginning of November, the CMS (The Centers for Medicare & Medicaid Services) finalized their MACRA rules for reporting on data in 2018. The changes to these rules are affecting healthcare organizations across the nation as they are scrambling to get prepared. With less than 60 days til the first of 2018, healthcare clinics and practices are ensuring they have what they need for accurate reporting measurements.

Reporting Time Switches from 90 Days to Full Year

The original quality reporting period was scheduled for 90 days, which has now changed to the full year.

Physicians are unhappy with the new ruling as they have less than two months to prepare their organizations for its rollout. The CMS, who focused on quality with the 90-day reporting window is now shifting to focus solely on the quantity of measures. This could have a negative impact on smaller healthcare organizations.

To comply with the new rulings, organizations would have to have EHRs that efficiently and accurately report their data. Implementing new EHRs takes a significant amount of time and may not be cost-effective with the tight deadline. Having a larger organization would make this more feasible. CMS has taken this into consideration with the new rules and provided a low volume reporting threshold.

Low Volume Threshold

There are some clinics and healthcare organizations that are exempt from this rule. Medicare Part B provider charges of $90,000 or less will not have to participate in MIPS. If healthcare organizations have less than 200 Part B beneficiaries, they will also exempt from quality reporting measurements.

The CMS believes that the number of clinicians still eligible for reporting after all exemptions will only equal 39%.

Meaningful Measures and MIPS Category Weight

The MIPS category weights have shifted quite dramatically with the new rules. In the second MIPS performance year, 10% of payments will be evaluated through cost-cutting. This was increased from 0% to 10%. Their goal was to ease into the following year, 2019, which would call for 30%. Many were disappointed in this rule as there are many measures that are still being ironed out. The cost-quality measure may negatively affect physicians or care in the short-term. The new categories include the following weighting:

Cost: 10%

Activities for Improvement: 15%

Advanced Care Info: 25%

Quality: 50%

Hardship Exemptions

The CMS is thinking about the negative impact of natural disasters on clinics and small practices. They will have the ability to file for exemption if their practice has been affected. This exemption applies to the Advanced Care Info category.

In conclusion, the changes that were made in this latest ruling have a direct impact on a lot of healthcare organizations. If they already had plans in place for incentive measurements and reporting, they will be changing the way they do things in this upcoming year.

If you are one of those organizations and are unsure where to start, Extract Systems can help you with reporting quality measures, efficiently and accurately. Speak to someone today to discover how.


About the Author: Kari Siegenthaler

Kari Siegenthaler is a Marketing Specialist for the Marketing Department at Extract. Kari attained her Bachelor of Arts degree in mass communications and convergent media at the University of Wisconsin – Eau Claire. Wearing the “hat of all trades,” she has an unusual, hybrid ability to write narratives, creatively craft meaningful messages, and design graphically compelling images. Kari is passionate about effective communication and developing strategy plans that allow Extract to succeed and excel way beyond their goals.