WASHINGTON (FRONTLINE MEDICAL NEWS) – Simple steps can be taken now in fee-for-service practices that can help predict performance in 2019, when the Medicare Access and CHIP Reauthorization Act (MACRA) goes into effect. The first key is to complete all necessary metrics for 2016, according to an American College of Physicians official.

For example, although meaningful use will no longer exist after this year, many aspects of it will continue to be applied and reported under the MACRA rules, Shari Erickson, vice president of governmental and medical practice at the American College of Physicians, said during the Hot Topics session at the annual meeting of the American College of Physicians.

“It will take some time for how things are measured to be reimagined, so we are advising members to try to test meaningful use, because what you’ve learned by doing that will be very helpful as you move” into the Merit-Based Incentive Payment System (MIPS), Ms. Erickson said.

Another way reporting can help is to participate in the Physician Quality Reporting System (PQRS) this year. The measures in this program will be streamlined under the new law, but the flavor will be the same, according to Ms. Erickson. Additionally, not taking the time to report this year not only will set physicians back in their ability to gauge readiness for what’s to come but also could cost considerable money.

“The 2018 adjustments based on 2016 reporting can be as much as [negative] 9% if you’re not doing any reporting at all,” she said in an interview.

Another step is to begin implementing quality improvement programs now. Doing so not only will improve PQRS measures while the program still exists, but also could help earn credit for clinical practice improvement activities that will account for 15% of MIPS scores in the first year under the new law.

Because the new law requires the Centers for Medicare & Medicaid Services to provide feedback to physicians on overall performance on MIPS scores, Ms. Erickson said that reviewing physician feedback reports as they already exist can help determine current ratings. Another way to determine performance ratings is to survey patients directly, she said.

Under the new law, practices have the option each year of choosing to be paid under the MIPS program or an alternative payment model, Ms. Erickson said, so even gradual shifts toward putting in place patient-centered-medical-home sorts of protocols will help MIPS-based performance ratings and increase the chances of earning more under an alternative model in the future.To facilitate those efforts, physicians can conduct a risk stratification of current patient panels and access how care is being delivered by learning about what the ACP calls “high value care.” The ACP has developed a resource center featuring documents addressing these questions for members.

But most importantly, Ms. Erickson said, is to learn about the law and to contribute to the comments section on the proposed rule before the comment period closes at 5 p.m. on June 27, 2016.

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