Why MACRA is probably a good thing for allergists

, | January 3, 2017

Why MACRA is probably a good thing for allergists

By now you’ve probably heard more than you care to about the Medicare Access and CHIP Reauthorization Act (MACRA), which became effective on Jan. 1. But did you know MACRA may actually be a GOOD thing for allergists, all things considered? Importantly, the Centers for Medicare and Medicaid Services (CMS) is now listening to physicians and has incorporated physician feedback – including the College’s Advocacy Council comments – into MACRA.

Here are some of the ways MACRA will benefit allergists – especially when you compare it to previous Medicare reporting programs (Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Payment Modifier (VBM)).

1. Elimination of the Sustainable Growth Rate (SGR)

Remember the SGR formula that annually threatened allergists with drastic Medicare pay cuts? That era of uncertainty for allergists and their Medicare patients came to an end with the passage of MACRA, which permanently eliminated the SGR.

2. Low Volume Exclusions

MACRA provides exclusions for an estimated 32% of all allergists with low Medicare volumes. Clinicians with Medicare charges less than or equal to $30,000 OR with 100 or fewer Medicare patients per year are exempt from the program. The previous Medicare reporting programs (MU, PQRS and VBM) had no such exclusions; all low volume allergists who didn’t participate received penalties.

3. Lower penalties for non-performance and better bonuses for good performance

Merit Based Incentive Payment System (MIPS) penalties will range from 4% in 2019 to 9% in 2022 and beyond. However, combined penalties from MU, PQRS and VBM were even higher. In 2018 penalties will range from 7% to 9% depending on practice size – and they were scheduled to increase in future years. Allergy practices that do not participate in MIPS in 2017 and beyond will see penalties decrease.

On the other hand, allergy practices that do successfully participate in MIPS may see bonuses of up to 4% in 2019 and up to 9% in 2022 and beyond. And exceptional performers are eligible to receive additional bonuses of up to 10%.

4. Fewer reporting requirements for 2017 transition year

In 2017, the MIPS transition year, allergists only need to report ONE quality measure or ONE improvement activity to avoid a penalty.

And, to help you understand the alphabet soup of MACRA, the College has developed a MACRA Acronym Table.

While MACRA isn’t perfect, some of its provisions do benefit allergists. Keep checking College Insider for updates on this important topic.