The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) repealed the broken Medicare sustainable growth rate (SGR) formula and established new payment pathways for physicians. To implement MACRA's reimbursement reforms, the Centers for Medicare & Medicaid Services (CMS) developed the Quality Payment Program which includes:
- The Merit-based Incentive Payment System (MIPS), as a modifier for fee-for-service payments beginning in 2019.
- Alternative Payment Models (APMs).
Making Sense of QPP
MIPS Eligibility and Preparedness
Individual pathologists and group practices can now check their eligibility for the MIPS performance year by using the CMS’ Quality Payment Program (QPP) lookup tool. The CAP also provides resources to help pathologists comply as the CMS implements and administers MIPS and APM programs.
Use our MIPS calculator to estimate future Medicare payment adjustments using your practice data and project the impact to your bottom line.
Pathologists Quality Registry
The Pathologists Quality Registry can improve practice performance, through benchmarking against other pathology practices, and make it easier for pathologists to qualify for bonuses under MIPS. If you would like information on our Pathologists Quality Registry, our qualified clinical data registry, complete the inquiry form to schedule a call with a member of our registry team.
How to Comply with MIPS
Pathologist Quality Measures
Identify relevant measures to help avoid Medicare payment penalties and earn bonuses when reported correctly.
Clinicians need to attest to Improvement Activities (IA), which represent 15% of a pathologist’s MIPS score, to receive credit in this category. Read answers to IA questions to learn all you need to know about Improvement Activities.
Members may login to access Improvement Activities we have identified as applicable to pathologists participating in MIPS.
To help pathologists successfully navigate the new and evolving payment models, the CAP launched a series of 30-minute webinars. During each session, recognized CAP experts explain the components MIPS and how to successfully comply with MIPS requirements.
- CMS QPP Education Site
- 2017 Performance Feedback User Guide
- 2017 Performance Feedback Fact Sheet
- How to Request a Targeted Review
- How to Access Performance Feedback for APM Entities
- How to Access Performance Feedback for Individuals
- How to Access Performance Feedback for Groups
- How to Access Performance Feedback for Voluntary Submitters
We have a dedicated team to help you navigate to MIPS reporting success.
Phone: 800-323-4040, option 3