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Medicare Payment System

The new Medicare Payment system that was designed by Medicare Access and CHIP Reauthorization Act (MACRA) was reviewed by the Office Management and Budget (OMB). The review process will be a crucial step in the process of officially establishing the amendments in the new Medicare payment system. Once the amendments are officially authorized, they will be used as an alternative to the existing Medicare Sustainable Growth Rate Formula (SGR). However, the report says that before the new set of rule takes place, they need to be authorized by the Federal Register. Individuals and organizations that are willing to comment on this are welcomed by the Federal Register for negotiations.

Meanwhile, MACRA said that all the eligible professionals and physicians would have to adopt either of the two Medicare Payment systems from 2019 onwards. As part of this future adaptation, the physicians can now get familiar with the new payment systems and raise their doubts on the same at the concerned authorities.

Two Payment Systems

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Office Management And Budget

As mentioned, the authorities have come up with two payment systems. The first and the one that deserves more attention now is the Merit-Based Payment System (MIPS). This system works on the basis of the annual MIPS score. As per the estimates, the adjustment range is estimated to be 4% negative or 4% positive. Meanwhile, the current estimates indicate that most providers who take part in the program will not be able to secure any adjustment in the systems.

The new payment systems are scheduled to be in effect from 2019. Following that, all the existing restrictions on payment adjustments will be hiked. When the new systems will take effect, the rate will be as low as 4%. However, by the year 2022, it will rise to 9%. The same rate will be used in the following years.

The amount of negative adjustment for low scoring providers who take part in the MIPS will rise up to 9% if they manage to keep with the requirement of revenue neutrality. However, this depends on how they utilize the program and its conditions.