Donald Trump’s election as President and Republicans controlling the Senate and the House predict that some type of congressional action with the Affordable Care Act (ACA) will occur. Unlike the ACA, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will NOT undergo significant legislative changes – since this bipartisan legislation passed in the Senate in April with a vote of 92 to 8.

Providers are caught in transition between furnishing quality patient care in a fee-for-service, volume driven system into a value-based system. January 1, 2017 will embark upon the YEAR OF TRANSITION. MACRA’s Merit-based Incentive Payment System (MIPS) allows providers three options:

  • Option One – allows for less than 90 days of performance data and only includes the measures from the Quality Category;
  • Option Two – includes performance data from all 4 categories (quality, cost, improvement activities and advancing care information), and;
  • Option Three – reports a full year of performance from all 4 categories.

A fourth option is to participate in an Advanced Alternative Payment Model (APM) such as Medicare Shared Savings Track 2 or 3 in 2017.

Not Participating is NOT an option for Medicare reimbursement.

The Multiple Chronic Conditions Resource Center provides current and relevant policy and practice updates to support the care and management of the largest, fastest growing and costliest US patient population – those with multiple chronic conditions.