MACRA/MIPS Consulting

What is MACRA?

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law on April 16, 2015. MACRA repeals the previously used Sustainable Growth Rate formula and changes the way that Medicare rewards physicians with value instead of volume. This pay for performance program streamlined multiple quality programs under one program – the Quality Payment Program (QPP). The QPP offers two new tracks to reimbursement: Merit-Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

What is MIPS?

MIPS is a new payment track under the QPP where you earn a performance-based adjustment to your Medicare payment. Designed to be budget neutral, think of it as the Hunger Games of Healthcare.

  • Meaningful Use

  • Physician Quality Reporting System

  • Value-Based Modifier

Trying to stay on top of MACRA/MIPS and its requirements can be extremely challenging for practices. It consumes time and effort that could otherwise be focused on the heart of your practice – taking care of patients. In response to the growing complexities of this program, Prima Healthcare Solutions began offering our MIPS consulting services. Our clients have been extremely pleased with the positive outcomes they have witnessed working with us. We can help you see a great return on investment while contributing to savings in both time and financial resources.

Program Overview

Primary Practice Assessment

At Prima Healthcare Solutions, each individual practice is unique. Before proposing a consulting service package, we provide a complimentary review of your practice’s current position to determine what level of assistance is needed. Once we are able to pinpoint your needs, we can make recommendations based on our findings.

Annual Monitoring

We work with you throughout the year to ensure that you are staying on top of your current needs and performance. We will guide you, maintaining a pulse on your measure rates, so that you can avoid penalties and obtain positive payment adjustments.

Attestation 

When attestation time rolls around, we are in the trenches with you, ensuring CMS attestation accuracy. We keep communication lines open with you and the partners we work with to ensure that attestation time is as easy as possible.

Pricing

We offer two-tiered pricing, based on the amount of work it will require to create and maintain a successful MIPS program within your organization. Smaller practices can achieve MIPS success with a level of expertise they might not have had in reach before. Larger organizations will also find cost savings – especially compared to their return on investment.

2021 Proposed Program Changes

Additional changes are coming down the pipeline for the MACRA/MIPS program in 2021. With feedback from clinicians and stakeholders that MIPS remains overly complex, they are proposing a new participation framework – MIPS Value Pathways (MVPs). This new framework, beginning in the 2021 performance period, alters the participation model of MIPS. Moving away from siloed activities and measures and towards an aligned set of measure options more relevant to the clinician’s scope of practice, it is a significant shift in the way clinicians currently participate.

 

Prima Healthcare Solutions is prepared to help your practice navigate these uncertain waters with confidence. Give us a call or click the button below and let us know how we can best serve you!

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Let us know how we can help your practice thrive.

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