The Healthmonix Advisor

How The 2018 Congressional Spending Bill Affects MACRA

Posted by Lauren Patrick on March 8, 2018
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On February 9th, a new Congressional spending bill was signed into law, ending our second government shutdown in less than a month. The Bipartisan Budget Act of 2018 keeps the government funded until March 23, boosts spending on military and domestic programs for two years, extends the debt ceiling, increases aid for recent natural disasters and to fight the opioid crisis, and extends the Children’s Health Insurance Program (CHIP) for an additional four years (on top of the six years authorized earlier in 2018).


But those with an interest in Value Based Care should also note that this bill implements important changes to The Merit-Based Incentive Payment System (MIPS), one of the payment tracks under MACRA. Specifically, for the second through fifth years of MIPS paymentsthrough 2021the “Cost” category could continue to be weighted at 10 percent of each physician’s overall score. This is in contrast to the original schedule, which saw the Cost category move from 10 percent in 2018 up to 30 percent in 2019.

RELATED: MIPS Performance Categories in 2018

Before 2018, Cost was tracked through administrative claims and MIPS eligible clinicians could view their performance feedback, but it did not affect their MIPS score at all. When the final rule for 2018 was released last November, some industry leaders shared concerns that the Cost category’s rate of increase in weight over the next few years would introduce too high a burden on providers.

In response to the changes laid out in the 2018 Congressional spending bill, MGMA senior vice president Anders Gilberg tweeted: “The Bipartisan Budget Act of 2018 is largely a win for physician practices. Reducing burden in the #MIPS program, eliminating the unelected Medicare cost-cutting board known as the #IPAB, and averting a flawed misvalued-code policy that would have resulted in drastic across-the-board payment cuts in 2019 and 2020 are all top @MGMA priorities.”

This bill also includes provisions of S. 870, the “Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017;” and H.R. 3120, legislation to ease the “meaningful use burden on providers and reduce the volume of future electronic health record-related significant hardship requests.”

Although the reporting burden may be reduced with this latest change, Value Based Care is here to stay. And as always, we highly recommend participating as early and as much as possible, both to maximize reimbursement and to set your practice up for long-term success. To that end, we've put together an entire (free!) MIPS Learning Center dedicated to answering your most common questions about the program, as well as a ton of educational resources to give you the information you need at every step. And for even more help reporting, check out MIPSPRO, which makes it easy to navigate complicated Medicare requirements and maximize your MIPS incentive. Our quality reporting team guides you through the MIPS reporting process, while our comprehensive, user friendly platform gives you real-time feedback on your MIPS performance.

Download your free MIPS Roadmap!

Topics: MACRA and MIPS