CMS Releases Detailed Advancing Care Information Measure Specifications; MACRA Tip of the Week: Advanced APM Participants Can Expect a Bonus in 2019

This week, CMS released updated measure specifications for the Advancing Care Information (ACI) category of MIPS on the QPP website. The requirements of the measures have not changed, but the descriptions are more detailed, similar to measure specifications previously released under the Meaningful Use program.

CMS has provided all the measures to download in a zip file format on this page: qpp.cms.gov/about/resource-library. To access the file, scroll about halfway down to "documents and downloads" and the measures are the eighth option. Once you have downloaded the zip file, be sure to choose the set of measures that corresponds to your EHR’s certification year. If you have 2015 technology, choose “measure specifications;” if you have 2014 technology, choose “transition measure specifications.”

As a reminder, the ACI category counts for 25% of the final MIPS score. Full details on the category are available on the ASCRS•ASOA MACRA Center webpage.

Tip of the Week: Nearly All Advanced Alternative Payment Model (APM) Participants in 2017 Will Earn a 5% Bonus in 2019

CMS has announced that it expects nearly 100% of eligible clinicians participating in an Advanced APM in 2017 to earn the 5% bonus in 2019. If you think you participate in an APM, such as a Medicare Shared Savings Track 2 or 3 ACO or a Next Generation ACO, be sure to contact your APM administrators to ensure you are included in the APM’s participant list to receive the bonus.

Under MACRA, Advanced APM participants are eligible for the bonus when the APM entities meet certain patient or revenue thresholds. For 2017, 25% of eligible patients or 20% of eligible revenues must be attributed to the APM entity. In data posted on the CMS QPP website, CMS predicts that based on claims data from 2016, nearly all APMs will meet the thresholds in 2017. It is important to note, however, that there are currently very few Advanced APMs available to ophthalmologists, However, many ophthalmologists do participate in APMs that don’t meet the requirements to be considered “advanced,” such as Medicare Shared Savings Track 1 ACOs, which do not have two-sided risk. Participants in these models, however, may earn credit through MIPS with their APM participation. Visit the APM page of the ASCRS•ASOA MACRA Center web page for full details on APMs under MACRA.

For more Top Tips and full program details, visit the ASCRS•ASOA MACRA Center or call the MACRA hotline at 703-383-5724. If you need additional assistance, please contact Allison Madson, manager of regulatory affairs, at amadson@ascrs.org