Posted and filed under Coding, Compliance, Healthcare.

If you’re in the healthcare industry – you’ve heard about MACRA. The Medicare Access and CHIP Authorization Act, Medicare’s two-track payment system for physicians and healthcare providers will be implemented on January 1st, 2017. Understanding the new system and rules that comes along with MACRA’s implementation is vital for the success of physicians and hospitals. The new set of CMS payment rules are based on the performance of care providers, but payments for quality of care services are not scheduled to begin until 2019.  This two-year gap is not something to take for granted, as MACRA comes with a host of information, regulations, and acronyms that must be researched, digested, and applied.

As a healthcare professional, you’re no stranger to the concept of acronyms. Between HHS, CMS, CPT, OIG, CPC, MD…there’s no shortage of acronyms to commit to memory – and MACRA will present a whole new slew of acronyms that require your attention. One way to begin understanding the basics of MACRA is to review the relevant acronyms associated with the new act.

Many physicians are not aware of the terms MACRA, MIPS, and APMs,” said John Harvey, MD, FACS, former president of the Medical Association of Georgia, who toured his state to discuss the impending Medicare payment system implementation. This statement by Dr. Harvey reveals an area of weakness in the industry; providers are unable, or unwilling, to learn additional systems and acronyms – and it’s at their own expense. January 1st is approaching rapidly, which means time is running out for providers who wish to be financially successful in the coming years.

Luckily, there is still time to learn the basics. As we mentioned previously, acronyms are a perfect starting place for physicians behind the curve on welcoming MACRA as the premier Medicare payment model.

Below you will find the quintessential MACRAnyms to help position you as a leading provider in Quality-based care.

  • QPP: Quality Payment Program. This program’s purpose is to reward high-value patient care and has two tracks for physicians to choose from; APMs and MIPS.
    • APMs: Alternative Payment Models. This payment track is a shared savings program in which  the physician must use a certified electronic health record (EHR) and use similar quality measures as under MIPS.
    • MIPS: Merit-based Incentive Payment System uses four components to base physician performance, quality, cost, clinical practice activities, and advancing care information (ACI).
  • ACI: Advancing Care Information. Replaces meaningful use (MU), was designed to simply meet the needs of physicians throgh flexibility and supported patient care. ACI reduces the reporting burden by allowing more engagement with the patient to improve care over period of time.
  • CHIP: Children’s Health Insurance Program, which offers coverage to children in families that earn too much money to qualify for Medicaid.
  • CPC: Comprehensive Primary Care, CMS’ 4-year initiative that aims to improve primary care. You may recognize this initiative from its launch in 2012.
  • CPC+: Comprehensive Primary Care Plus, a five-year model created with the intention of strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation. Set to launch January 2017.

These are simply a few of many acronyms that will become increasingly popular in a post-MACRA implementation world. If you’re looking for more information on MACRA and its associated terms, the CMS website and AAFP can provide you with additional resources.