3 Ways to Avoid MACRA Penalties for 2019

So here’s the deal: MACRA officially starts January 1, 2019. And while that may seem like light years away, you could actually be in danger of getting a Medicare penalty (a hefty 4 percent!) based on your reporting habits now.

But the good news is that you don’t need to report much to avoid the penalty. In fact, you have to report so little MACRA calls it “Minimal Reporting.”

If you have the correct Minimal Reporting on just one of the three categories listed below, CMS won’t penalize you in 2019. Piece of cake, right?

We built Luma with MACRA and MIPS in mind by ensuring that our features can specifically apply to special Quality measures.

1. Report Quality

Deadline to report: 2/28/2018

Category Weight for 2017 Score: 60%

Minimal Reporting

Remember “1:1:1.” To nail the minimal reporting on Quality, make sure you report one quality measure for one patient for one point in time in 2017. Yep, you read that right. You don’t need hordes of patients to nail the Minimal Reporting in the Quality category.

How to easily report on Quality:

This MIPS category replaces the old Physician Quality Reporting System (PQRS).

Want to see which quality measures you can report for your specialty clinic? Visit CMS’s official Quality category page here. There are a total of 271 measures listed as of now, and you can filter them by category priority, submission method (EHR, administrative claims, registry, etc), and by your specialty (31 listed). We’d start by organizing the list by specialty then submission method, so you don’t have to comb through all the measures that don’t apply to you.

Let’s say you’re a cardiac care specialist. First, filter the measures by “Cardiology” and you’ll see 20 measures pop up specific to cardiology. One of them, “Coronary Artery Disease: Antiplatelet Therapy,” requires you to report the percentage of patients 18 and over diagnosed with CAD who were prescribed aspirin or clopidogrel. Now that you have your quality measure, you can easily track which patients over a given time period meet this measure.

Did you know we’ve built Luma with MACRA and MIPS in mind? A lot of our features can specifically apply to special Quality measures, so you don’t have to worry about meeting MIPS requirements — and you’d probably meet more than you knew!

2. Report Improvement Activities

Deadline to report: 3/31/2018

Category Weight for 2017 Score: 15%

Minimal Reporting:

Show consistent use of one improvement activity over a consecutive 90-day period in 2017.

How to easily report on Improvement Activities:

If you can’t meet Minimal Reporting on Quality, your next best bet is to meet it on Improvement Activities. All you need to do is attest (but make sure you have documentation of your activity in case of an audit).

Visit CMS’s official Quality Payment Program for Improvement Activities here. There’s a bunch of activities (93, to be exact) you can choose from no matter your specialty. Chances are, you’re probably doing one of these activities already. They range from reporting on training in care coordination to tobacco screening and intervention.

But here’s the catch: while you have some flexibility with the duration you’re reporting on Quality measures, you don’t have that same flexibility with Improvement Activities.

You can filter the Improvement Activities by subcategory (care coordination, patient safety and practice assessment, etc). But if you’re meeting your Minimal Reporting, just hone in on the one that your clinic already does. For example, the “Use of patient safety tools” measure is one your clinic probably already implements.

Watch our on-demand webinar to learn more about how to leverage reimbursable HIPAA-compliant virtual visits to deliver care and minimize appointment backlogs and cancellations.

3. Report Advancing Care Information

Deadline to report: 3/31/2018

Category Weight for 2017 Score: 25%

Minimal Reporting:

Attest to meeting 4 measures for the base score for at least 90 consecutive days in 2017.

How to easily report on Advancing Care Information:

Advancing Care Information, or ACI, officially replaces Meaningful Use. The ACI you report for 2017 depends on the year your EHR is certified (2014 or 2015, or a combination of both). You can identify your EHR edition here. If you don’t have a certified EHR, you can apply for a Hardship Exception if you’d like CMS to reweigh your total score without counting this category.

Keep in mind it’ll be a pain if you don’t have certified EHR going forward since the ACI category is here to stay.

Out of all the measures, we think the ACI is the hardest to report since you need to:

1. Ensure your EHR is certified and even after it is, you have to

2. Ensure you can meet all four measures outlined for the ACI Minimal Reporting (we’d go with reporting on Quality or Improvement Activities).

When Minimal Reporting Doesn’t Cut It

We know some practices are having a hard time transitioning to the Quality Payment model. But if you can, keep CMS super happy with you from the start.

Doing so, you’ll become a superstar MACRA and MIPS expert and you could walk away with a nice bonus percentage for 2019, too. And who doesn’t like bonuses?

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