Medicare Physician Payment

MACRA and MIPS Physician Payment Program

Physician Select Management can help you with Medicare MACRA / MIPS data collection and reporting for Eligible Clinicians (ECs)
or groups wishing to attest starting with a 90 day reporting period for 2017

Your practice management system and electronic medical record help you run your business, but you can also meet the requirements to maximize payment under the new compensation methodologies from Medicare. As “Meaningful Use” transitions into the MACRA / MIPS payment systems, thousands of dollars from CMS are at stake, and your readiness (or lack thereof) this year and next could have a huge impact on how much you may be paid (or penalized). If you are using your system the way it should be used, then why leave money on the table?

Experienced PSM staff can help you set up your system correctly and show you how to track your compliance in order to qualify for MACRA/MIPS payments. Our services help expand your knowledge in the areas that are not only most critical to complying with MIPS, but also to help you run your practice more efficiently.

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced three quality programs (the Medicare Electronic Health Record (EHR) Incentive program, the Physician Quality Reporting System (PQRS), and the Value-Based Payment Modifier (VM) with the Quality Payment Program (QPP). There are two main tracks in the QPP: APM and MIPS. Most practices will fall into the MIPS category. The new QPP program will give Medicare physicians and clinicians a chance to be paid more for giving better care. For much more detailed information, please refer to: https://qpp.cms.gov/docs/Quality_Payment_Program_Overview_Fact_Sheet.pdf

Or you can have us help you cut through all of that to optimize your system for compliance by taking advantage of one of the following:

Pick your pace in MIPS:

If you choose the MIPS track of the Quality Payment Program, you have three options.

  • Don't Participate

    Not participating in the Quality Payment Program: If you don’t send in any 2017 data, then you receive a negative 4% payment adjustment.

  • Submit Something

    Test: If you submit a minimum amount of 2017 data to Medicare (for example, one quality measure or one improvement activity), you can avoid a downward payment adjustment.

  • Submit a Partial Year

    Partial: If you submit 90 days of 2017 data to Medicare, you may earn a neutral or small positive payment adjustment.

  • Submit a Full Year

    Full: If you submit a full year of 2017 data to Medicare, you may earn a moderate positive payment adjustment.

The size of your payment adjustment will depend both on how much data you submit and your quality results.

Participate in the Advanced APM track: If you receive 25% of Medicare covered professional services or see 20% of your Medicare patients through an Advanced APM in 2017, then you can earn a 5% Medicare incentive payment in 2019.

PSM MACRA / MIPS Consulting Services

Option One - PSM Coordination with ECW MIPS Services - $500

A PSM eCW specialists will assist and coordinate with the eCW MIPS Services consultant/project manager with calls and follow-up. No travel is required.

Option Two - Monitoring of the MIPS Dashboard and feedback to the practice's Primary Contact

  • Weekly, advised for those starting close to the October 2, 2017 cutoff date – additional $50 per report until the practice/Eligible Clinicians (ECs) are successful
  • Bi-Weekly, for those who want to keep a close eye on the data collected to achieve a higher performance score – $100 per report
  • Monthly, with a Gap Analysis and confidence in practice/ECs workflow – $150
  • If no other monitoring has been done, or previously attempt was unsuccessful – $300
  • 90 days, for those who have no issues in the Gap Analysis and have an efficient workflow – $450

Options can be used to build confidence in the workflow and reporting, in a manner best suited to the practice’s needs.

* Travel billed separately, at cost

Option Three - PSM Implementation and assessment with ongoing monitoring and reports - $1750 + Monitoring Options(s)

  • Advise/Assist with required system settings
  • Provide documentation defining the MIPS program as it pertains to your ECs
  • Assist with selection and setup of the MIPS Dashboard for data collection with Registry or EHR reporting of the Quality measures and Advancing Care Information objectives
  • Assist with selection of the Improvement Activities and documentation to support self-attested objectives
  • Perform a Gap Analysis – onsite up to 4 hours included – of workflow and gaps in data collection methods
  • Produce a plan for implementing changes to the workflow
  • Implementation – on-site up to 4 hours included – of workflow changes to meet the reporting requirements*
  • Options for monitoring of the MIPS Dashboard and feedback to the practice’s primary contact
  • Weekly, advised for those starting close to the October 2, 2017 cutoff date – additional $50 per report until the practice/ECs are successful
  • Bi-Weekly, for those who want to keep a close eye on the data collected in order to achieve a higher performance score – $100 per report
  • Monthly, with a Gap Analysis and confidence in practice/ECs workflow – $150
  • If no other monitoring has been done previously or was unsuccessful – $300
  • 90 days, for those who have no issues in the Gap Analysis and have an efficient workflow – $450

Options can be used to build confidence in the workflow and reporting, utilized in a manner best suited to the needs of the practice/ECs

* Travel billed separately, at cost

Additional assistance offered - pricing to be determined

  • Advise and assist with registration for Public Reporting for Immunization, Specialty or Syndromic Surveillance Registries
  • Advise, assist and/or perform Security Risk Analysis within the reporting period

* Travel billed separately, at cost