‘Top Docs’ show on Medicare’s new payment program now online

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A recording of a recent Medical Association of Georgia (MAG) ‘Top Docs Radio’ show that addressed Medicare’s new Quality Payment Program (QPP) for physicians is now available online.

Elizabeth Woodcock with Woodcock & Associates – one of the state’s leading third party payer and practice management experts – says that, “The QPP offers two reimbursement options for physicians, including the Advanced Alternative Payment Model (APM) and the Merit-based Incentive Payment System (MIPS).”

She adds that, “The Centers for Medicare & Medicaid Services (CMS) says that 2017 will be a key transition year and an important learning and development period.”

In terms of key points, Woodcock explains that…

– If a physician doesn’t bill at least $30,000 in Medicare Part B allowable charges or they see less than 100 Medicare patients per year, they are exempt from the QPP. This includes more than 30 percent of all physicians who are billing for Medicare Part B services.

– CMS will collect data on costs – but only “behind the scenes” as this MIPS pillar will not count for the 2017 performance year. Its ‘weight’ was transferred to the Quality category, which will count for 60 percent of the physician’s performance score.

– Improvement activities constitute another MIPS pillar. However, just four activities need to be reported by physicians – and none if you are already recognized as a medical home.

– The number of required EHR “meaningful use” (now known as “Advancing Care Information,” the fourth and final MIPS pillar) metrics has dropped from 11 to five – but it is still necessary for physicians to report on more measures to achieve a maximum score of 100 percent.

– CMS is committed to increasing the number of physicians who are in Advanced APMs. While the opportunity to join one for 2017 is not realistic given the lack of availability and registration deadlines, CMS has pledged to create a new “ACO Track One” model that will count as an advanced APM as of 2018. Participating in an Advanced APM is ideal, as it offers an automatic five percent incentive payment for all Medicare patients.

Woodcock also stresses that, “The QPP will begin in 2017, with MIPS reporting required by March 31, 2018. This initial performance year will establish the physician’s Medicare payments in 2019, with an adjustment of up or down to four percent. If an eligible physician fails to submit any 2017 data, they will receive a negative four percent payment adjustment.”

MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG's ‘Top Docs’ show has reached more than 8,300 listeners – which includes people in all 50 states and 84 countries.

MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.

Woodcock is a nationally recognized practice management expert. For more information about her books or to schedule a speaking engagement, contact Woodcock at elizabeth@elizabethwoodcock.com or 404.373.6195. Go to www.elizabethwoodcock.com for additional information.

Click to listen to ‘Top Docs Radio’ show recording

Click for MAG’s MACRA/MIPS web page