From Volume to Value: An Overview of MACRA, MIPS, APMs and the New CMS Quality Payment Program

Duration: 60 Minutes
In this session Mr. Wolfe will help highlight key components of the anticipated 962 page proposed rule (Proposed Rule). Discussion will include overview of CMS's new Quality Payment Program. Mr. Wolfe will provide a straight-forward, practical explanation of key MACRA provisions and the Quality Payment Program, including the timing and features of new MIPS and APM incentive implementation.
Merit-based Incentive Payment System
Instructor: Joseph N Wolfe
Product ID: 501808
Objectives of the Presentation
  • Who does MIPS apply to and what factors impact a physician's MIPS score?
  • What does MIPS offer over the Alternative Payment Models?
  • What changes will providers need to have in place in order to be ready to meet the performance and reporting obligations?
Why Should you Attend
Attendees should register because they need to be paying close attention to the structure and program specific details on CMS's Quality Payment Program, MACRA, MIPS and APM incentive implementation.

Counsel to healthcare systems and independent physicians must prepare now and quickly learn and understand the new MACRA requirements to meet the proposed Jan. 1, 2017, deadline for performance and reporting obligations that will determine professional payments for 2019. (i.e., the 2019 bonus/penalty adjustments will be based on the 2017 performance metrics).

Areas Covered
  • MACRA and CMS' Quality Payment Program Overview
  • Discussion on the consolidation of PQRS, Physician Value-based Payment Modifier, and Medicare EHR Incentive Program to create MIPS
  • Learn how those who care for Medicare beneficiaries under MACRA are being paid
  • Describe incentives for participating in certain alternative payment models (APMs)
  • Insights on CMS' Quality Measure Development Plan for transition into Quality Payment Program
  • Identify the impact that this plan could have on your Medicare revenue (positive or negative)
  • Review the CMS Programs which are proposed to be included under the APM Path for the 1st year
Who will Benefit
  • In-House Counsel
  • Health Care Executives
  • Health Care Human Resources
  • Health Care CFOs
Topic Background
The passage by Congress of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) caused the repeal of the Medicare sustainable growth rate (SGR) methodology and signaled a sea change in the way Medicare rewards clinicians for providing quality care.

On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) released a much anticipated 962 page proposed rule ("Proposed Rule") that outlines specific details on how CMS intends to implement MACRA value-based payment reform under a new framework called the Quality Payment Program.

The Proposed Rule includes program-specific details on how CMS intends to establish the Merit-based Incentive Payment System ("MIPS"), a new program that consolidates components of three existing programs, the Physician Quality Reporting System ("PQRS"), the Physician Value- based Payment Modifier, and the Medicare EHR Incentive Program. The proposed rule also would establish incentives for clinician participation in certain alternative payment models ("APMs").
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Instructor Profile:
Joseph Wolfe is an attorney with Hall, Render, the largest health care focused law firm in the country, now with offices nationwide. Mr. Wolfe provides advice and counsel to some of the nation's largest health systems, hospitals and medical groups on a variety of health care issues. He regularly counsels clients on a national basis regarding compliance-focused physician compensation and alignment strategies. He is a frequent speaker on issues related to the physician self-referral statute (Stark Law), hospital-physician transactions, physician compensation governance and health care valuation issues. Before attending law school at the University of Wisconsin, he served as a combat engineer in the United States Army.
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