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What allergists need to know about MIPS – (and why PQRS still matters)

April 11, 2016

What allergists need to know about MIPS – (and why PQRS still matters)

Over the next several years there will be some major modifications to the Medicare quality reporting systems. The SGR repeal not only gave physicians relief from the onerous regulations of the sustainable growth rate (SGR), but it also took another step along the quality highway by heavily tying your reimbursement under the physician fee schedule with your quality performance. Starting in 2017, providers will be assessed in four new areas which comprise the merit based incentive payment (MIPS) program. First is the redrafted meaningful use measure; second is quality (measured by PQRS); third is resource use / cost (measured by the value-based modifier); and fourth is clinical practice improvement activities. Your MIPS performance in 2017 will result in positive or negative adjustments to Medicare payments in 2019.

So why does any of this matter, especially if your practice sees few Medicare patients? As MIPS expands and as commercial payers adopt payment plans based on value and quality, it will eventually mean a significant gain or loss for you based upon your performance and reporting. And since one of the key components of MIPS is quality/PQRS, one of the best ways to prepare for MIPS is to begin PQRS reporting now.

Fortunately, the College has the resources you need to start PQRS reporting, as well as up-to-date information on registering for the Group Reporting Option.

  1. Confused about PQRS or unsure where to start? Check out the new ACAAI PQRS toolkit, which provides information about 2016 reporting options, suggested measures for allergists, and information on how to obtain free, personalized PQRS help. There ARE ways for allergists to participate successfully; one good option is the asthma measures group under the qualified registry reporting method.
  2. Physicians can participate in PQRS as either Individuals or as part of a Group Practice. If you choose the Group Practice option, you must inform CMS of your election by registering to participate in the 2016 PQRS Group Practice Reporting Option (GPRO). GPRO Registration is open between April 1, 2016 and June 30, 2016.

The Advocacy Council will continue to cover all the changes in MIPS and quality reporting in a series of articles now under development. Stay tuned for more!

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