Updates to Medicare's Quality Payment Program That May Impact You

* Context.--Within Medicare's Quality Payment Program, and more specifically the Merit-based Incentive Payment System, pathologists stand to potentially lose or gain approximately $2 billion during the initial 7 years of the program. If you or your group provides services to Medicare beneficiaries, you will likely need to comply with the program. Objective.--To avoid potential reductions in Medicare reimbursement, pathologists need to understand the requirements of these new payment programs. Data Sources.--Each year the Centers for Medicare & Medicaid Services publish a Final Rule detailing the program requirements and updates. 2020 marks the fourth reporting year for the Merit-based Incentive Payment System. Performance this year will impact 2022 Medicare Part B distributions by up to [+ or -] 9%. Conclusions.--By staying up to date with the ever-evolving Merit-based Incentive Payment System requirements, pathologists will be better equipped to successfully comply with this relatively new payment system, reduce the burden of participating, understand the reporting differences of the various performance categories, and thereby be able to maximize their scoring and incentive potential. (Arch Pathol Lab Med. 2020;144:679-685; doi: 10.5858/arpa.2019-0376-RA)
In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA), which was game-changing for our health care system. (1) This legislation replaced the sustainable growth rate system and [...]