More Alphabet Soup

By: Susan D’Agostino, RN

MACRA, MIPS, APMs…the list goes on. 

Just when you think you have them all down, CMS (Centers for Medicare & Medicaid Services) comes up with more. 

Let’s go through a brief breakdown of what all these acronyms mean.

MACRA– Medicare Access and CHIP Reauthorization Act of 2015

MACRA repeals the Medicare Sustainable Growth Rate (SGR) formula that calculated payment cuts for physicians.  It creates a new framework for rewarding physicians for providing higher quality care by establishing two tracts for payment:

  • MIPS (Merit Based Incentive Payment System) – will make payment adjustments based on performance on quality, cost and other measures, and will consolidate components of three existing programs—the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and Meaningful Use (MU).
  • APMs (Alternative Payment Models) – are a payment model expanded under the Center for Medicare and Medicaid Innovation (CCMI) with the exception of Health Care Innovation award recipients, a Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO), or a Medicare Health Care Quality Demonstration Program or Medicare Acute Care Episode Demonstration program. APMs can apply to a specific clinical condition, a care episode, or a population.  An Advanced APM allows a practice to earn more for taking on some risk related to their patients’ outcomes. 

For more information on the Quality Payment Program visit: https://qpp.cms.gov/measures/performance

How can PrecisionBI (PBI) help?

Built exclusively for healthcare providers, PBI can assist a practice in accessing their necessary critical reporting requirements.  With PBI, viewing in dashboards and drilling down to the discrete data elements becomes effortless, and you’ll gain the ability to design and run ad hoc reports.

Contact us at PBI Contact today, to learn more about our analytics solution or to set up a demo.