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Deconstructing Medicare quality programs

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Have some alphabet soup.

This analysis breaks down the MACRA proposed rule. MACRA stands for this mouthful: the Medicare Access and CHIP Reauthorization Act. MIPS (below) stands for the Merit Based Incentive Payment System. Government programs, dating back to the New Deal, in the ’30s,  are rife with abbreviations.

As this piece in HealthAffairs reports:

“As outlined in MACRA, the proposal would consolidate three currently disparate Medicare quality programs into MIPS:  (1) the Physician Quality Reporting System; (2) the Value-Based Modifier Program; and, (3) the ‘Meaningful Use’ of electronic health records. CMS proposes that eligible clinicians receive a composite score relative to their performance in each of four categories. Quality measures for these core domains will be selected annually, with the data regarding clinician performance on the measures made available via the Physician Compare Web site.

“The four performance categories are:

  1. “Quality: 50 percent of total score in year 1;
  2. “Advancing Care Information: 25 percent of total score in year 1, formerly EHR Meaningful Use;
  3. “Clinical Practice Improvement Activities: 15 percent of total score in year 1, this is essentially the ‘new’ domain added to the previously existing other three.
  4. “Cost or Resource Use: 10 percent of total score in year 1, based on Medicare claims data — no reporting necessary.”

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