Get answers to some of the most frequently asked questions about MACRA and the Merit-based Incentive Payment System (MIPS).
Help pages are available for each MIPS performance category:
FAQ Topics
- General
- Payment
- Quality
- Advancing Care Information (ACI)
- Improvement Activities (IA)
- Patient Engagement
General
What year is MediTouch certified for?
2014. Do not be misled by the use of 2014 in 2014 Certified EHR. In this case, 2014 means that our technology is certified for the years 2014, 2015, 2016, and 2017.
What are the two Quality Payment Program tracks?
Merit-based incentive System (MIPS) and Advanced Alternative Payment Models (APMs)
Which program does MediTouch assist with?
MIPS
What Medicare volume is required to attest?
$30,000 and 100 Medicare patients a year. If you are below either, you cannot attest.
It is my first year with Medicare. Am I required to attest?
No. First-year Medicare providers are excluded. You are not required to attest until the subsequent year after enrolling in Medicare.
Who are Eligible Clinicians (ECs)?
Physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists
What types of providers may be added in year three of MIPS?
Physical therapists, occupational therapists, speech therapists, nurse midwives, and social workers may be added as ECs.
I am not an eligible clinican. Can I still attest?
Yes. Data can be submitted with a group or individually. However, only ECs are eligible for the payment adjustment.
What exclusions can I apply for?
First year, volume, and non-ECs
What are the three 2017 MIPS performance categories?
Quality (previously PQRS), Advancing Care Information (previously Meaningful Use), and Improvement Activities
What is the fourth category not included in 2017?
Cost
Payment
To which year does the payment adjustment apply for not reporting in 2017?
2019
What is the maximum penalty for not reporting in 2017?
4%
What is the maximum incentive for reporting in 2017?
4%
What is the minimum amount required to avoid the penalty?
If you submit a minimum amount of 2017 data to Medicare (e.g., one quality measure or one improvement activity at any time in 2017), you can avoid a downward payment adjustment.
What is the payment adjustment for reporting data for 90 days?
Neutral or positive payment adjustment.
What is the payment adjustment for reporting data for a full year?
Moderate positive payment adjustment
How do I maximize my adjustment?
The size of your payment will depend both on how much data you submit and your performance results. Attesting for a full year and achieving or exceeding our recommended goals will help maximze the adjustment amount.
Does the MediTouch scoring system guarantee a high percentage payment adjustment?
No. The final score determined by CMS is graded on a bell curve. If a high number of providers achieve a better score, your payment adjustment will be negatively affected. MediTouch cannot predict how every provider will score.
Quality
What programs did the Quality category replace?
PQRS and MU Clinical Quality Measures. The same measures are used.
What weight percentage does Quality account for in the MIPS scoring?
60%
What is the MediTouch recommended goal?
80-90 percentage points
Are individual Quality measures graded on a bell curve?
Yes
What type of measures are required?
At least one outcome measure. If one outcome does not apply, one high-priority measure can be reported.
What denominator volume is required?
20
Do I get credit for submitting a measure with less than 20 denominators?
Yes, 3%.
What patient-specific module can you use to manage Quality measures?
What is the Quality Patient List used for?
Tracking measure population and updating applicable ones.
Advancing Care Information (ACI)
What program did ACI replace?
Meaningful Use
What weight percentage does ACI account for in the MIPS scoring?
25%
What is the MediTouch recommended goal?
100 percentage points
Are individual ACI measures graded on a bell curve?
No, just the final combined score
Combining base, performance, and bonus scoring, what is the total percentage points available?
155
What percentage is ACI capped at in the final score?
100
What is required to attest to this category?
Base measures
What are the base measures?
e-Prescribing, Health Information Exchange, Provider Patient Access, Security Risk Analysis
What are the performance measures and their percentage points?
Refer to Advancing Care Information on the CMS website.
What are the bonus measures and their percentage points?
Refer to Advancing Care Information on the CMS website.
Improvement Activities (IA)
What program did IA replace?
There was no direct program.
What weight percentage does IA account for in the MIPS scoring?
15%
What is the MediTouch recommended goal?
20 points for 15 providers or less. 40 points for 16 or more providers.
Are individual IA measures graded on a bell curve?
No, just the final combined score.
How many points do medium-weighted activities account for?
10
How many points do high-weighted activities account for?
20
Do I get an credit for being a PCMH provider?
Yes. Full credit is automatically earned.
Patient Engagement
Does scoring well in the patient scorecard guarantee a high incentive?
No. The scorecard is general information and does not directly reflect the MIPS scoring. The results are not provider-specific. However, as long as the activity was performed in the same month that the patient encounter was performed, a high MIPS score can be inferred.
What is the patient engagement list used for?
Tracking the patient population per provider in the selected reporting period in attempt to get the patient engaged with the portal.