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What is the MACRA Final Rule?

On October 14, 2016, CMS issued the Medicare Access and CHIP Reauthorization Act (MACRA) final rule, that established new payment programs and changes the way Medicare reimburses physicians and other providers. Starting January 1, 2017, eligible physicians need to be on one of two new Quality Payment Program (QPP) payment tracks established by MACRA:

  1. MIPS – A merit-based incentive payment system (most commonly used by Optometrists and Ophthalmologists)
  2. APM – Advanced alternative payment models



  • The goal of MIPS is to streamline reporting to CMS and improve care
  • It consolidates three reporting programs into one – (Meaningful Use, PQRS, and the Value-based Modifier (VBM) – which will all sunset)
  • MACRA does not change reporting requirements or payment for hospitals or Medicaid providers
  • Physicians receive a final score based on a scale of 0 to 100 demonstrating how they performed under QPP. The more points they accumulate, the more incentive they stand to make
  • Eligibility requirements are:
    • Must bill more than $30,000 to Medicare
    • Provide care to more than 100 Medicare patients per year
    • Must have participated in Medicare in 2016 or before


2017 is the First MIPS Reporting Year


Performance Areas & Weights

MIPS has four categories that will determine an eligible provider’s score and revenue:

  1. QUALITY – Replaces PQRS
  2. IMPROVEMENT ACTIVITIES – New Category for Care Coordination
  3. ADVANCING CARE INFORMATION – Replaces Meaningful Use
  4. COST – Replaces the Value-Based Modifiers


Reporting Options

Reporting for 2017 will affect 2019 payment. The performance period for 2017 is a minimum of 90 days for all categories with some limited exceptions. The last day to report for 90 days is October 2, 2017. Physicians must submit 2017 attestations no later than March 31, 2018.

MIPS Reporting Options


Financial Impacts


Quality Reporting

My Vision Express’ integration with the IRIS Registry will assist in the performance percentage for attest station. To get started with this registry please follow the instructions in the link here.

My Vision Express will also be partnering with the AOA More Registry with an expected release at the end of Q2 of 2017.

To view the measures that are related to the Optometric and Ophthalmic fields, please refer to the following link here.


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