1. for the 2017 Transition Year
MACRA
Quality Payment Program
MIPS: “Pick Your Pace”
for the 2017 Transition Year

2. 2017 MIPS Transition Year
CMS published final rule, which implemented certain MACRA provisions on October 14, 2016
Final regulation MIPS allows providers to “pick your pace” for the 2017 MIPS performance period, allowing providers to choose at which level they would like to participate
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
Enacted into law on April 16, 2015
Repealed the flawed Sustainable Growth Rate (SGR) formula for determining Medicare payments for health care providers’ services
A new framework for rewarding health care providers for giving better care not more just more care
Quality Payment Program
CMS Allows You to Pick Your Pace

3. Timing of MIPS Transition Year
Submit
Adjustment
Performance
year
Feedback
available
2017
Performance Year
March 31, 2018
Data Submission
Feedback
January 1, 2019
Payment Adjustment
Performance: The first performance period opens January 1, 2017, and closes December 31, 2017.
Send in performance data: To potentially earn a positive payment adjustment under MIPS, send in data about the care you provided and how your practice used technology in 2017 to MIPS by the deadline, March 31, 2018.
Feedback: Medicare gives you feedback about your performance after you send your data. 
Payment: You may earn a positive MIPS payment adjustment beginning January 1, 2019, if you submit 2017 data by March 31, 2018.
The first performance period for MIPS will be from January 1, 2017 through December 31, Remember, that during the first performance period, eligible clinicians have the “pick your pace” option in determining their level of participation.
The first payment year for MIPS, where eligible clinicians will have their payments adjusted, will be in 2019, and will be based on the first performance period of 2017.
Quality Payment Program
CMS Allows You to Pick Your Pace

4. Pick Your Pace: Options for Participation1
Submit something 2
Submit for part of the year 3
Submit for a full year 4
Don’t participate
Quality Payment Program
CMS Allows You to Pick Your Pace

5. Option 1: Test the Quality Payment Program
Submit minimum amount of 2017 data to Medicare
Avoid a 4 percent penalty
Quality Payment Program
CMS Allows You to Pick Your Pace

6. Option 1: Test the Quality Payment Program
What is a “minimum” amount of data?
One quality measure; or
One improvement activity; or
Required Base Score Advancing Care Information measures
Quality Payment Program
CMS Allows You to Pick Your Pace

7. Option 2: Participate for Part of the Calendar Year
Physicians may submit 90 days of 2017 data to Medicare
Doing so may earn physicians a positive payment adjustment, depending on performance
If you’re not ready on January 1, you can start anytime between January 1 and October 2
Please note: You must submit performance data by March 31, 2018
Quality Payment Program
CMS Allows You to Pick Your Pace

8. Option 3: Participate for the Full Calendar Year
Physician may submit a full year of 2017 data to Medicare
Doing so may earn physicians a positive payment adjustment
Best way to earn largest payment adjustment is to submit data on all MIPS performance categories
Performance year starts on January 1, 2017
Quality Payment Program
CMS Allows You to Pick Your Pace

9. Option 3: Participate for the Full Calendar Year
Full participation in MIPS means the clinicians should, at least, meet the following criteria:
Report six quality measures
Report four medium-weighted or two high-weighted improvement activities
Report Advancing Care Information measures
Important to note:
Positive adjustments are based on performance, not the amount of information or length of time providers reported
Quality Payment Program
CMS Allows You to Pick Your Pace

10. MIPS Payment Adjustment: Based on Data Submitted
Full-Year Participation
Is the best way to get the max adjustment
Gives you the most measures to choose from
Prepares you the most for the future of the program
Partial-Year Participation (Report for 90 Days)
You can still earn the max adjustment
Quality Payment Program
CMS Allows You to Pick Your Pace

11. Option 4: Do Nothing
Not participating in the Quality Payment Program for the transition year will result in a 4 percent penalty
Quality Payment Program
CMS Allows You to Pick Your Pace

12. Four Options: Pick Your Pace
Description
Timeline
2019 Payment Adjustment 1
Test the Quality Payment Program
Submit some data in 2017
Avoids 4 percent penalty 2
Participate for part of the calendar year
90 days of 2017 data between January 1 and October 2
May earn a positive payment adjustment 3
Participate for the full calendar year
Full calendar year 2017 4
Do not participate
2017
4 percent penalty applied
NOTE: Some practices may choose to participate in an Advanced Alternative Payment Model in 2017
Quality Payment Program
CMS Allows You to Pick Your Pace