The ACR offers a variety of resources to help radiologists understand what MACRA is, to stay informed on MACRA implementation, and take steps to thrive in new payment and delivery models.
Watch: MACRA – CMS Quality Payment Program Year 2: An Overview for Radiologists
Download our decision guide for radiologists to help you be MACRA-ready.
What is the Merit-Based Incentive Payment System?
If you participate in traditional Medicare fee-for-service rather than an Advanced APM, you will earn a performance-based payment adjustment to your Medicare payment through MIPS.
MIPS allows Medicare clinicians to be paid for providing high-quality, efficient care through success in four performance categories as shown below. Each category is weighted and added into a final performance score. Weights shown are for 2018.
- Quality (50%) – Replaces Physician Quality Reporting System (PQRS) Most radiologists will report up to six quality measures including an outcome measure.
Download a list of MIPS measures relevant to radiologists
- Promoting Interoperability (25%) – Replaces the Medicare EHR Incentive Program, also known as Meaningful Use
Most ACR members would likely be automatically reweighted to zero for the PI category as non-patient-facing eligible clinicians or hospital-based eligible clinicians.
- Improvement Activities (15%) – New performance category
Most participants will be required to complete up to four improvement activities. Small, rural and shortage area practices or non-patient-facing MIPS clinicians need half that requirement to meet the full performance criteria.
Download a list of MIPS improvement activities suggested for radiology
- Cost (10%) – Replaces cost component of Value Modifier program
The cost category will measure Medicare Spending per Beneficiary (MSPB) and total per capita cost (similar to the previously known Value-Based Modifier Program). Cost will be calculated using claims and will not require data submission
Quality Payment Program
What to Know
Clinicians can participate in MIPS or in APMs in order to avoid downward payment adjustments and potentially receive upward adjustments.
What are advanced Alternative Payment Models?
An APM is a payment approach based on risk and reward for providing coordinated, high-quality, efficient care. Advanced APMs are a subset of APMs that take on some risk related to patient outcomes.
In the QPP, you may earn a 5% Medicare incentive payment during 2019 through 2024 and be exempt from MIPS if you have sufficient annual participation in an Advanced APM, based on percent of Part B payments or patients.
What to do next
Determine if you are:
- Required to participate in MIPS; exemptions may apply
- Eligible to participate as an individual or group
- A patient-facing or non-patient-facing clinician
- Reporting via EHR, qualified registry, qualified clinical data registry or claims
Take Action
In 2018, radiologists can maximize their value in QPP by focusing efforts on Quality and Improvement Activities:
- Examine feedback reports to gauge prior year adjustments from legacy programs (PQRS, VM and MU)
- Participate in ACR National Radiology Data Registries to report radiology-specific measures to satisfy the Quality Performance Category and potentially earn Improvement Activity points
- Participate in the Radiology Support, Communication and Alignment Network to earn points toward the Improvement Activities performance category
MACRA Toolkit
Use these tools, including videos, articles and ACR analyses, to better understand and prepare for quality-based changes to radiology care.
Additional Resources
Patient- and Family-Centered Care
Explore materials to enhance your understanding of—and participation in—new practice and payment models and help you provide more patient- and family-centered care.
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