MACRA/MIPS: What UPG Providers Need to Know

UPG is committed to ensuring that our providers understand the programs under MACRA, and we plan to share developing information as relevant to our UPG clinicians. We understand that many of you are likely to hear specifics about these programs from your specialty societies as well. Those specifics may or may not be applicable to you as an UPG member.  Rest assured: We are focusing on these programs and understand their import to our valued providers. Please don’t hesitate to reach out with any questions or concerns, or if you seek further clarification:

Here are 4 facts regarding MACRA/MIPS, relevant to UPG providers:

  1. Under MACRA, there are two reimbursement structures: MIPS (Merit Based Incentive Payment System) and APMs (Alternative Payment Models). Because we are in a fee for service environment, we qualify for the MIPS structure —  not APMs.
  2. All UPG clinicians benefit from the fact that UPG is a large organization with over 1,000 providers. We report our performance measures as a practice group, and our MIPS composite performance score is calculated as such. Providers most at risk for penalization under MIPS regulations are solo specialty providers, solo practitioners and small groups. UPG providers do not face such risk.
  3. While penalization isn’t an immediate concern, as we look to the future and the MIPS requirements become more stringent we will need to focus efforts on performance measures:
      • Quality
      • Resource Use
      • Clinical Practice Improvement
      • Meaningful Use of Certified EHR Technology
  4. Physicians can contribute individually to group performance by:
      • Thorough documentation of patient care
      • Diligent management of screening, managing and monitoring patient conditions
      • Providing input as necessary with regard to EHR system technology

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