APMA News - May/June 2018 - 70

IT Consultant
By James R. Christina, DPM

Why Doesn't APMA Do Something about MACRA/MIPS?
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There continue to be concessions for solo and small group
APMA frequently hears from members frustrated by the
Medicare program known as MIPS (Merit-based Incentive Paypractices (practices with 15 or fewer eligible providers)
ment System). MIPS is part of the Quality Payment Program
including:
(QPP), which is a result of legislation-MACRA (the Medicare
◆ a bonus of five MIPS points for participating in any one
Access and CHIP Reauthorization Act of 2015).
of the MIPS categories in 2018;
MACRA repealed the flawed Sustainable Growth Rate (SGR)
◆ double weighting for improvement activities (continformula for Medicare that projected cuts in physician reimued from 2017); and
bursement each year; Congress would pass yearly legislation to
◆ opportunity to apply for exception from Promoting Inavoid the cuts, which were getting to the point of being greatteroperability (PI; formerly Advancing Care Information),
the category that requires the use of an ONC Certified
er than 20 percent. Health-care organizations were united in
EHR (if you are eligible and apply,
welcoming the elimination of the
this exception re-weights the PI
SGR-and in opposing the burAPMA
will
continue
to
category to 0 percent and takes
den imposed by the QPP and
quality from 50 to 75 percent).
MIPS. APMA, along with many
advocate for a reduced burden
other health-care organizations, offrom these intrusive government
fers comments on the MIPS proThe maximum payment adgram every year in an attempt to
justment for not participating in
programs that do nothing
reduce the burden it imposes on
MIPS in 2018, which is applied
to improve patient care.
our members, and there have been
to 2020 payments, is a 5-percent
some successes. However, repeal of
reduction.
the QPP would have to happen legislatively. MedPAC, ConWhile these "improvements" help somewhat, participation
in these programs reduces time providers can spend with pagress's advisory board on Medicare issues, is studying alternatients. Participation also imposes an administrative burden, as
tives to MIPS, and APMA is monitoring these developments
well as a cost to practices without any evidence of improvement
closely. However, as history demonstrated with the SGR repeal,
in the quality of patient care. In fact, many contend that all of
we should be careful what we wish for because any replacement
these
burdens on providers actually contribute to decreased
may be even worse.
quality of care for patients. Patients are also dismayed that proSome of the improvements that MIPS offers compared to
viders seem to spend more time looking at their computers
previous programs include:
than listening to patients' concerns. Patients who feel the docIt is not an all-or-none program with regard to each of the
tor is not paying attention to their needs may be more likely
categories. Each component has a maximum score you can
to pursue a malpractice suit if something goes wrong.
achieve, but you can get a score less than the maximum, unAPMA will continue to advocate for a reduced burden
like some previous programs in which you either met or did
not meet the requirements.
from these intrusive government programs that do nothThe exclusion threshold continues to rise, and for 2018,
ing to improve patient care. In the meantime, APMA will
the exclusion criteria are:
continue to provide resources that allow our members to
◆ less than or equal to $90K in Medicare Part B allowable; or
cope with the requirements of these programs, including
◆ less than or equal to 200 Medicare Part B beneficiaries.
lectures, webinars, articles, and resources, all available on
The lookup tool is now available to find out if you are exAPMA.org. For more information, visit www.apma.org/
cluded for 2018-all you need is your NPI number (if you
mips2018.
n
don't know it, you can look it up by visiting www.npinumber
lookup.org). NPIs are not protected information.
MIPS program implementation continues to be gradual.
Contact Dr. Christina at jrchristina@apma.org.
For 2018, a MIPS score of 15 is all that is needed to avoid
a payment reduction in 2020.

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70 APMA News May/June 2018

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Table of Contents for the Digital Edition of APMA News - May/June 2018