MACRA & Value Based Payment
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Pick Your Pace: Scoring Quality and Cost

Over the last year, you have heard a lot about MACRA and the shift to value-based payment. During this transition year, it’s important to note to that your performance in 2017 determines your payment adjustment in 2019. Collecting quality measure data now will help fulfill MACRA requirements and potentially lead to positive payment adjustments in the future.

Most family physicians will fall into the Merit-based Incentive Payment System (MIPS) path under the Quality Payment Program (QPP)—created as part of MACRA. Under MIPS, members’ Medicare Part B payments will be adjusted based on scores from four performance categories, including quality and cost.

Fortunately, you may already be collecting some data that’s required. Many features of the MIPS quality category come from the previous Physician Quality Reporting System (PQRS), whereas many features of the cost category come from the previous Value-based Payment Modifier (VBPM) program.

To help you prepare for the quality and cost performance categories, the AAFP has a variety of resources available including:

  • Informational handout (4 page PDF)—Making Sense of MACRA: The Value of Quality and Cost breaks down quality and cost performance categories.
  • MIPS overview—The AAFP’s MACRA Ready resource website, houses a variety of MIPS information to help you understand quality-based changes and prepare your practice.
  • Quality performance—Explains the quality performance category under the MIPS track.
  • Cost reporting—Reviews the payment year weights under MIPS.

Remember, performance in 2017 determines payments in 2019 and measures collected now will help fulfill MACRA requirements. Don’t delay.

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