CMS Reporting Requirements for Primary Care
Under CMS's Quality Payment Program (also known as MACRA, the Medicare Access and CHIP Reauthorization Act of 2015), physicians caring for Medicare patients must participate in one of two tracks:
Merit-based Payment System
The Merit-based Payment System (MIPS) – ties Medicare payments to performance against CMS benchmarks for quality, promoting interoperability, improvement activities and cost.
- MIPS is a complex program with a significant administrative burden
- Part B payment adjustments can be positive or negative up to 9%, depending on performance
OR
Advanced Alternative Payment Model
An Advanced Alternative Payment Model (Advanced APM) – is a better way to meet requirements without the risk of a penalty, while awarding providers a higher annual increase on their Part B payments.
- Advanced APM participants are not required to complete MIPS reporting