QPP, MIPS & Alternative Payment Models

CHIME recognizes that for payment and delivery reform to succeed, we need a high-performing, interoperable and secure technical infrastructure. CHIME strongly supports steps CMS has taken to improve the flexibility by which clinicians use health IT to drive better outcomes. The first performance year for the programs established under the Medicare Access and CHIP Reauthorization Act (MACRA) is 2017, so Medicare physicians will now be reimbursed based on their participation in the Quality Payment Program (QPP), either in the Merit-based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). MACRA applies to Medicare physicians and clinicians, but not to other providers like Medicaid clinicians and hospitals creating different rules for different providers. In reviewing the MACRA rules, we see a few significant challenges that may impede provider success: 1) the lack of interoperability among and across our disparate health system; 2) the need for better synchronization across all CMS reporting programs; 3) vendor readiness; and 4) the need to simplify program requirements.

 

CHIME Top Recommendations to Policymakers

  • Make 2018, in addition to 2017, a transition year, given that MACRA establishes an entirely new and complicated regulatory structure
  • Stage-3 Meaningful Use-like measures and use of Version 2015 CEHRT should not be required any sooner than 2019
  • Align program requirements as closely as possible with the hospital setting and with other CMS reporting programs

CIO Cheat Sheets 

Letters to the Administration

Congressional Letters & Testimony

CMS Resources

Year 1 Resources (2017)
Proposed Changes to Year 1 (2017) & Year 2 (2018)