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Hot Topic - 11/9/2017

New MACRA final rule specifies changes for 2018

The new year is almost upon us. If you are participating in MACRA, that means new program changes you need to be prepared to address. Last Thursday, CMS published the final rule outlining the changes to the MACRA program for 2018. Here is our summary of the changes that will have the biggest impact on providers participating in MACRA next year. 

Key changes to MACRA for 2018

• The threshold for participating has been set at $90K in Medicare Part B billing or 200 Medicare-enrolled patients for the year. With the new threshold, fewer providers will qualify to report as individuals, but many will still qualify to report as part of a group. 
• Cost plays a greater role in the performance score, increasing in weighting from 0 percent in 2017 to 10 percent in 2018. There is no reporting requirement because CMS calculates cost based on claims. Cost will be calculated based on data for the entire year.
• The reporting period for Quality data is increasing from 90 days to 12 months. The reporting periods for the Advancing Care Information and Improvement Activities categories are increasing to 90 days.
• CMS is making MACRA participation easier for small practices – those with fewer than 15 providers – by awarding them bonus points that will factor into their composite MIPS score.
• Bonus points are also available to providers caring for patient populations determined to be particularly complex based on a combination of Hierarchical Conditions Category (HCC) risk scores and the number of dually eligible patients treated.

Please note, if you plan to participate in MACRA as part of a virtual group in 2018, you need to notify CMS by Friday, December 1. You can register your MACRA virtual group using the Virtual Group Toolkit
MedPac evaluating the future of MIPS

In October, the Medicare Payment Advisory Commission (MedPAC) began a discussion about the future of the MIPS participation track, a discussion the congressional advisory body will continue in its December meeting. While this may result in changes to MIPS long-term, these discussions are not expected to result in any changes to 2018 participation requirements.

The LHP staff is working on updated MACRA guides that will offer more detailed guidance on 2018 participation. These will be available in January.


Our apologies: E+ currently unavailable outside Legacy

A recent upgrade to Legacy’s education portal, E+, resulted in it being unavailable to providers outside of Legacy. Our Information Services department is working on the issue. We’ll let you know as soon as E+ is available for you to access the LHP Learning Modules.

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