MACRA

MACRA unified and replaced measures previously recorded through Sustainable Growth Rate, PQRS, Value Payment Modifier, and Meaningful Use Incentive.

MACRA unified and replaced measures previously recorded through Sustainable Growth Rate, PQRS, Value Payment Modifier, and Meaningful Use Incentive.

We focus on the MIPS pathway for reporting on individual providers.

CMS assigns each anesthesiologist and CRNA a “MIPS Composite Performance Score” (CPS) ranging from 0 to 100. The higher your individual score, the more money you can earn. If your score were <15 for failure to report in 2019, you would have been penalized 4%. As your score rises, your penalty decreases, and you can even earn positive adjustments up to +4%.

Providers with a CPS > 70 will be deemed “Exceptional Performers” and are eligible to split an additional $500 million bonus pool courtesy of CMS. These penalties and bonuses may continue to increase over time.

Four components make up your final CPS. Because anesthesia is typically deemed “non-patient-facing”, the formula is different than formulas for providers in other specialties.

CMS controls a widely published list of quality measures referred to as “MIPS Measures.” While there are many such measures, very few of them apply to the practice of anesthesia. For instance, “MIPS 426- Handoff in PACU” is designed for anesthesia.

We recommend reporting “Non-MIPS Measures”. These become available upon registering with a “Qualified Clinical Data Registry” (QCDR). The right QCDR will greatly affect overall costs, complexity for your providers, and feasibility of becoming compliant. QCDRs tend to put their initials in front of these “Non-MIPS Measures”. For example, you may see “ASA 12: Perioperative Mortality Rate” or “ABG 14: Corneal Abrasion”. The leading initials typically indicate which QCDR “owns” the measure and is responsible for its annual certification through CMS. There are currently 5 such “Non-MIPS Measures” that must be shared between competing QCDRs.

Continuous Quality Improvement Activities (CPIA) include:

Through our partnership with Graphium ONE™, Medical Business Management offers MACRA compliance with the use of our iOS app for $459 per provider per year. This includes QCDR registration fees and does not require an interface with your facility or billing company. We allow for the collection of additional fields to assist in measuring your operational performance and quality (i.e., ready times, turn-over-times, etc.) at no extra charge.

Just download Graphium EMR in the Apple App Store, and you’re ready to start collecting your quality and operational data. We also offer many other services, including paper-based data collection, full tablet-based EHR, and EHR interfacing for compliance, charge capture, and operational excellence.