Thursday, November 10, 2016

Understanding the MACRA final rule

 Sunrise Services Home


MACRA Final Rule creates a new Medicare Quality Payment Program with two "paths":

MIPS- Merit-based Incentive Payment System

  • If you decide to participate in traditional Medicare Part B, then you will participate in MIPS where you earn a performance-based payment adjustment.

APM-Alternative Payment Models

  • If you decide to participate in an Advanced APM, through Medicare Part B you may earn an incentive payment for participating in an innovative payment model.


Who is eligible to participate?


  • Physicians
  • PA's
  • NP's
  • CNS
  • CRNA

Who is not able to participate?

  • Hospitals/Medicare part A payments
  • FQHCs/RHCs and Medicaid Providers (there is no dual eligible progam)

How can you be excluded from participation?

  • You are a 1st year clinician
  • You don't see patients
  • You do less than 30K and/or have 100 Medicare patients
  • You qualify for the Alternative Payment Model



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