MACRA and Value-Based Payment Models: Regulatory Changes and Reimbursement Implications

1.0 CME Credit

1.0 CE Credit

ABQAURP sub-specialty credits: Patient Safety/Risk Management 1.0, Physician Advisor 1.0, Managed Care 1.0, Case Management 1.0

MACRA, MIPS, and APMs...Oh My! Currently, Medicare measures the value and quality of care provided by doctors and other clinicians through a patchwork of programs, including the Physician Quality Reporting System, the Value Modifier Program, and the Medicare Electronic Health Record (EHR) Incentive Program. Through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Congress streamlined and improved these programs into one new Merit-based Incentive Payment System (MIPS). Most Medicare clinicians will initially participate in the Quality Payment Program through MIPS.

Although only in a proposed state now, the rule would improve the relevance and depth of Medicare's value and quality-based payments and increase clinician flexibility by allowing clinicians to choose measures and activities appropriate to the type of care they provide. MIPS allows Medicare clinicians to be paid for providing high quality, efficient care through success in specific performance categories.

Alternatively, clinicians who take a further step towards care transformation--participating to a sufficient extent in Advanced Alternative Payment Models (APMs)--would be exempt from MIPS payment adjustments and would qualify for a Medicare Part B incentive payment.

Discover how these changes will impact your practice, hospital, or health system.

This session was recorded live at our 2017 Annual Health Care Quality & Patient Safety Conference and is a portion of the online course entitled: A Multifaceted Approach to Health Care Quality and Patient Safety.

At the conclusion of the activity, attendees will be able to:
  • Discuss the MIPS and Advance APM tracks of the MACRA Quality Payment Program "QPP"
  • Explain new CMS payment models and the trajectory for 2018 and beyond
  • Appreciate how physicians and leading health systems are thinking about non-FFS based payment models
  • Examine how 'variable reimbursement' is likely to impact physician reimbursement and compensation moving forward
This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME credit and nursing contact hours offered for each profession.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

ABQAURP designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hour through the Florida Board of Nursing, Provider # 50-94.

This program is approved for Category 2 credit by the American Osteopathic Association.

All participants must achieve a final assessment score of at least seventy percent (70%) for recertification and continuing education credits. You have 60 days to complete the course after ordering. Please note: Exam candidates taking the Core Body of Knowledge and Diplomates renewing their certification may have less time to complete, as determined by deadlines imposed.

This activity is valid from July 26, 2017 through March 15, 2020.

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COURSE FEES: Diplomate $29.00      Member $34.00      Non-Member $42.00

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About The Authors
Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this online activity.

Nathan Bays, JD
Nathan Bays is the Managing Director of the Cain Brothers' Health Systems Mergers and Acquisitions Group. Mr. Bays' responsibilities focus on strategic transaction advisory engagements with health systems, academic medical centers, community hospitals, and physician networks and groups. Nathan also serves as Senior Policy Advisor to The Health Management Academy.

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