Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) on April 16, 2015, which repealed the Sustainable Growth Rate (SGR) formula used to determine Medicare physician fee-for-service payments.
In SGR’s place, MACRA requires physicians to choose between two major payment tracks: the fee-for-service Merit-Based Incentive Payment System (MIPS), and advanced alternative payment models (APMs). To do this, the Centers for Medicare & Medicaid Services (CMS) created the Quality Payment Program (QPP) to implement the two tracks for physicians and other eligible clinicians.
The QPP is an annual program that affects Medicare payment two years later. The first QPP performance year was Jan. 1 - Dec. 31, 2017. Physicians required to participate in the 2017 QPP must submit data to CMS by March 31, 2018.
To see if you’re exempt from having to submit data for the 2017 QPP performance year, check the MIPS lookup tool. If you’re not exempt, check the list of 53 Texas counties to see if you qualify for a separate MIPS exemption. If you participated in an advanced APM in 2017, check the APM lookup tool.
All data for the 2017 QPP performance year must be reported to CMS by March 31. If you’re required to participate in the 2017 MIPS track, take action now to avoid a 4-percent Medicare payment penalty in 2019. If you participated in the advanced APM track in 2017, contact your APM administrator to ensure all required data specific to your model will be sent to CMS on your behalf.
QPP Reporting Deadlines:
Looking for easy steps? Check out How to Submit the Bare Minimum to Avoid 2019 MIPS Penalty.
After you or your vendor sends data to CMS, check your performance scores on the QPP portal.
How to Send 2017 Data
TMA Practice Consulting offers quality improvement services to help prepare physician practices for MACRA. TMA's practice management consultants can conduct a MACRA readiness assessment of your practice and provide customized on-site assistance to help you with your practice's specific needs.
The Physicians Advocacy Institute, in collaboration with health care consulting firm Healthsperien and TMA, created a MACRA Quality Payment Program education initiative. Visit the MACRA QPP Resource Center to get answers to your questions and access free resources.
Learn about MACRA and the QPP and earn CME credits.
MACRA QPP CME at TexMed 2018:
Quality Payment Program Overview free CME
Quality Payment Program in 2017: Pick Your Pace free CME
MACRA and Medicare — Get Clarity and Direction! CME at discounted rate
MACRA Penalties: Neutralize Them With New Revenue CME at discounted rate
MACRA QPP Webinars free CME (for some webinars)
Learn about the Quality Payment Program using TMA, American Medical Association, and CMS resources and tools.
Texas Medical Association
Medicare QPP Physician Education Initiative
Listen to Quality Payment Programs in Today’s Practice
Alphabet Soup: A MACRA Glossary and Acronym Guide
American Medical Association
Medicare Payment & Delivery Changes
Centers for Medicare & Medicaid Services
Quality Payment Program: Merit-based Incentive Payment System and Alternative Payment Models
2017 QPP Resource Library, Help and Support, Support and Available Options for Small, Underserved, and Rural Practices
2018 QPP Resource Library, 2018 QPP Fact Sheet, 2018 Final Rule Executive Summary
U.S. Department of Health & Human Services
How to Propose Your Own Physician-Focused Payment Model under MACRA
Fed Up With the MIPS Burdens? Tell the Feds Texas Medicine Today, Feb. 28, 2018
MIPS is Dead, MIPS is Dead; Well, Not Quite Blogged Arteries, Feb. 20, 2018
Five Things to Know As QPP Deadlines Approach Texas Medicine Today, Feb. 15, 2018
All of a Sudden, One Month Less for Claims-Based MIPS Reporting Texas Medicine Today, Feb. 14, 2018
TMA Takes Physicians’ Grievances to Washington Texas Medicine Today, Feb. 14, 2018
Budget Deal Includes Big Health Care Changes Texas Medicine Today, Feb. 9, 2018
Medicare Payments Cut? Apply for a Reconsideration Now Texas Medicine Today, Feb. 7, 2018
EHR Dashboard May Not Tell You Everything Texas Medicine Today, Jan. 30, 2018
Get a Medicare Bonus With New Bundled Payment Model Texas Medicine Today, Jan. 23, 2018
Very Few U.S. Physicians to See Medicare Bonuses This Year Texas Medicine Today, Jan. 19, 2018
MEDPAC to Congress: Get Rid of MIPS Texas Medicine Today, Jan 12, 2018
Medicare Streamlines QPP Submission Process Texas Medicine Today, Jan. 12, 2018
Take Action Now to Avoid 2019 Medicare Payment Penalty Texas Medicine Today, Jan. 4, 2018
TMA Convinces CMS to Give Harvey-Affected Physicians a Break Texas Medicine Today, Jan. 4, 2018
New Tools Available to Submit MIPS Data Successfully Action, Dec. 15, 2017
TMA Wins MIPS Exemption for Many Harvey-Affected Practices Action, Dec. 15, 2017
Are You Exempt From MIPS in 2018? Action, Nov.15, 2017
New MIPS Option Now Available Action, Nov. 1, 2017
Read More About MACRA
Explore the list of federally funded initiatives to help you transition to MIPS or APMs. All services are available to physicians and group practices at no or low cost.
Quality Payment Program – Small, Underserved, & Rural Support
TMF Quality Payment Program Network
Transforming Clinical Practice Initiative
Health Care Payment Learning and Action Network
The Innovation Center’s Learning Systems
Participate in MACRA activities, propose your own measures and activities, or give feedback.
Participate in Study on Quality Reporting Burdens and Get MIPS Credit
Submit ACI Measures and Improvement Activities for Consideration for MIPS
Participate in Clinical Subcommittees to Develop MACRA Episode-Based Cost Measures
Participate in CMS Measure Development Testing Related to Clinician Referrals
Comment on Physician-Focused Payment Model Proposals
TMA Advancing Care Information (ACI) Resource Center
TMA EHR Adoption Resources
CMS Quality Payment Program (QPP) Overview
MACRA QPP Physician Education Initiative
Got MACRA questions, call or email the Knowledge Center
To help you get the best information possible, TMA has identified direct links to MACRA news, resource centers, education, and advocacy from national specialty societies. Visit your specialty society online for information specific to your specialty, setting, and practice.
See our list.
Subscribe to Centers for Medicare & Medicaid Services (CMS) email lists to stay informed of new policies or changes to relevant Medicare programs and for the latest MACRA information. Stay up to date with MACRA deadlines and compliance dates by visiting TMA’s Deadlines for Doctors.
QPP Email Updates
CMS EHR Incentive Program Listserv
Medicare Learning Network National Provider Calls and Events
CMS Open Door Forums