- Participation in the Medicare Shared Savings Program (MSSP) is likely to increase performance scores under MACRA’s Merit-Based Incentive Payment System by as much as 30%, according to research by Caravan Health.
- Practices with high performance could earn up to a 25% payment adjustment in the 2018 performance year because of the CMS scaling factor and the exceptional performance bonus, the issue brief states.
- About 40% of eligible providers are expected to be in Track 1 MSSP accountable care organizations (ACOs), which have special scoring standards under MACRA.
This is the first year of collecting performance data under MACRA, which rewards providers for high quality care and compares them to other providers in their area. Although debate on the future of the ACA continues in Congress, MACRA seems safe. It was passed with bipartisan support and has been praised by lawmakers on both sides of the aisle.
More and more providers are expected to participate in ACOs and 480 ACOs are currently in the MSSP. ACOs have been shown to produce significant savings that increase with time.
“Hospitals can avoid hundreds of thousands of dollars in downward MIPS adjustments, and potentially earn the exceptional performance bonus by enrolling in an ACO to take advantage of special scoring for their clinicians,” the Caravan brief states. “Small practices should consider joining an ACO to avoid penalties for generally lower scores due to lack of infrastructure, and providers in rural areas may want to join ACOs to avoid MIPS penalties due to their higher cost structure.”