Prepare Now—Not Later—to Meet New Medicare Reimbursement Requirements

Rheumatologists who choose MIPS should also join the ACR’s Rheumatology Informatics System for Effectiveness (RISE) Registry, which will meet the MIPS Qualified Clinical Data Registry requirement.

 More on APMs
Providers who choose APMs as their reimbursement pathway will be exempt from MIPS if they receive significant revenue from qualifying APMs. As an incentive to choosing this reimbursement pathway, they will receive a 5% bonus in 2019–2024. Currently, all APMs are payer designated and are accountable for total spending, with no fundamental change in how much and for what physicians are paid (i.e., shared savings plus fee-for-service).

The ACR is interested in creating a physician-focused APM, which includes identifying areas for reduced cost or better care, identifying barriers in the current model (e.g., no payment-for-care coordination) and designing the APM to remove barriers and make provisions to ensure quality and/or reduce cost.

Mary Beth Nierengarten is a freelance medical journalist based in Minneapolis.

Resource

1. American College of Rheumatology. http://www.rheumatology.org/MACRA.