Originally published: . Volume 7, No. 5. Source pages: 7.
In a 962-page regulation published April 29, the Centers for Medicare and Medicaid Services (CMS) propose “a new frame work for rewarding health care providers for giving better care, not just more care.”
The rule originates from the Medicare Access and CHIP Reauthorization Act (MACRA) passed last year by Congress. The law offers certain eligible professionals a choice of payment models where they are rewarded for performance. These models are viewed by some to become guides for states and private insurance.
One of these models is the Merit-based Incentive Payment Systems, called MIPS. The other is the Alternative Payment Models or APMs. Reporting begins in 2017 and physicians will receive a composite performance score linked to bonuses and penalties, ranging from 4 percent in 2019 to 9 percent starting in 2022, according to sources.
“Eligible professionals” for the first two years of MIPS are: physicians, physician assistants, nurse practitioners, clinical nurse specialists, and nurse anesthetists.
For the third and succeeding years, other professionals become “eligible:” physical or occupational therapists, speech-language pathologists, audiologists, nurse midwives, clinical psychologists, clinical social workers, and dietitians/nutritionists.
The president of the American Medical Association, Dr. Steven Stack, said that the rules offer both opportunities and poses risks. The opportunities involve better rewards for improvements, and the risk is that regulatory approaches will drive “the alarming rate of physician burnout.”
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