Medicare Part B reimbursement to physicians will change significantly in 2019. The new legislation, called MACRA (the Medicare Access and CHIP Reauthorization Act) replaces the existing incentive structures – the Physician Quality Reporting System (PQRS), the Value Modifier (VM), and Meaningful Use – with a new system called MIPS (the Merit-based Incentive Payment System). Up to 9% of Medicare FFS revenue will be at risk based on MIPS performance. Unless physicians are in an advance alternative payment model (like an ACO or a bundled payment initiative), they will be exposed to MIPS. This applies to both primary care and specialty practices.
Although the payment system does not change until 2019, the baseline data tracking period, on which future payments will be based, begins on January 1, 2017. CMS is under fire to move this date back to allow physicians to learn about the new program and prepare, but no decision has yet been made on a delay. ACMS wants to assure that physicians are aware of the coming changes, and have access to free or low-cost technical assistance which is and will soon be available.