American Association of Clinical Endocrinologists

MACRA and AACE: 2019

What is MACRA?

New MIPS Resources are Now Available in the Quality Payment Program Resource Library

CMS has posted the following new Merit-based Incentive Payment System (MIPS) resources on CMS.gov:

  • QPP Overview

  • QPP Resource Library has over 100 resources which include information on:
  • 2019 Virtual Groups Toolkit: Includes an overview fact sheet, which details what virtual groups are and how to participate in a virtual group in 2019; an election process fact sheet that describes the process for forming a virtual group; a sample virtual group election submission email; and a virtual group agreement template.
  • 2018 Cost Performance Category Fact Sheet (updated): Offers an overview of the Cost performance category including how the cost performance category is weighted and scored.
  • 2018 Claims Data Submission Fact Sheet: Provides details on how to submit Quality performance category data through claims for the 2018 performance year.
  • 2019 QPP Final Rule, executive summaries etc.
  • 2019 MIPS Quick Start Guide MIPS Participation & Overview Fact Sheet
  • 2018 MIPS Scoring at a glance 2018 CMS Web Interface: Test your data
  • 2018 QPP Access User Guide, MIPS scoring 101 Guide, 2018 Comprehensive List of APMs snd more!
  • QPP Webinars/slides/FAQs etc. are located here https://qpp.cms.gov/about/webinars that assist with submitting MIPS data via the CMS web interface for the 2018 performance year and include resources and webinars for 2018 CMS Web Interface User Demonstrations, 2018 Quality Performance Category Overviews etc.
  • Timelines, important dates and deadlines!
  • Certified EHRs

Read Now: ONE MEMBER’S EXPERIENCE WITH THE DIABETES COLLABORATIVE REGISTRY


For more information on MACRA, please email MACRAinfo@aace.com


Quality Payment Program (QPP) is divided into two paths:

How do I Submit Data?

Standards for Advanced Alternative Payment Models (APMs)

  • Require participants to bear a certain amount of financial risk
    • Total risk (maximum amount of losses possible under the Advanced APM) must be at least 4 percent of the APM spending target.
    • Marginal risk (the percent of spending above the APM benchmark (or target price for bundles) for which the Advanced APM Entity is responsible (i.e., sharing rate) must be at least 30 percent.
    • Minimum loss rate (the amount by which spending can exceed the APM benchmark (or bundle target price) before the Advanced APM Entity has responsibility for losses) must be no greater than 4 percent.
  • Base payments on quality measures comparable to those used in the MIPS quality performance category
  • Require participants to use Certified EHR technology
  • Advanced APMs
  • All payer Advanced APMS
  • Check APM Participation Status

AACE Activities

  • NEW! AACE 2018 Webinar: QPP Year 2 CLICK HERE
  • AACE formed the Task Force on the Implications of MACRA Law for Members in the Fall of 2015.
  • AACE held a MACRA Summit follow-up meeting in the Summer of 2016.
  • The MACRA Task Force has drafted a preliminary Advanced APM for diabetes care. Anticipates presenting to commercial insurance carriers in the of Winter 2016/Spring 2017.
  • The MACRA Task Force has begun work on Thyroid and Osteoporosis MIPS quality measures.
  • AACE WEBINAR: Are your ready for MACRA? CLICK HERE

Endocrine Measures for MIPS Use

MEASURE NAME

NQF

QUALITY ID

NQS DOMAIN

Adult Kidney Disease: Blood Pressure Management

N/A

122

Effective Clinical Care

Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions

N/A

325

Communication and Care Coordination

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

104

107

Effective Clinical Care

Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients

N/A

406

Effective Clinical Care

Care Plan

326

47

Communication and Care Coordination

Communication with the Physician or Other Clinician Managing On-going Care Post-Fracture for Men and Women Aged 50 Years and Older

45

24

Communication and Care Coordination

Controlling High Blood Pressure

18

236

Effective Clinical Care

Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%)

66

118

Effective Clinical Care

Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation

417

126

Effective Clinical Care

Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear

416

127

Effective Clinical Care

Diabetes: Eye Exam

55

117

Effective Clinical Care

Diabetes: Foot Exam

56

163

Effective Clinical Care

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

59

1

Effective Clinical Care

Diabetes: Medical Attention for Nephropathy

62

119

Effective Clinical Care

Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

89

19

Communication and Care Coordination

Documentation of Current Medications in the Medical Record

419

130

Patient Safety

Falls: Plan of Care

101

155

Communication and Care Coordination

Falls: Risk Assessment

101

154

Patient Safety

Falls: Screening for Future Fall Risk

101

318

Patient Safety

Functional Status Change for Patients with Foot or Ankle Impairments

424

219

Communication and Care Coordination

Hypertension: Improvement in Blood Pressure

N/A

373

Effective Clinical Care

Medication Reconciliation Post-Discharge

97

46

Communication and Care Coordination

Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy

N/A

147

Communication and Care Coordination

Osteoporosis Management in Women Who Had a Fracture

53

418

Effective Clinical Care

Patient-Centered Surgical Risk Assessment and Communication

N/A

358

Person and Caregiver-Centered Experience and Outcomes

Pneumococcal Vaccination Status for Older Adults

43

111

Community/Population Health

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

421

128

Community/Population Health

Preventive Care and Screening: Influenza Immunization

41

110

Community/Population Health

Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

418

134

Community/Population Health

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

N/A

317

Community/Population Health

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

28

226

Community/Population Health

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

2152

431

Community/Population Health

Screening for Osteoporosis for Women Aged 65-85 Years of Age

46

39

Effective Clinical Care

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

N/A

438

Effective Clinical Care

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

24

239

Community/Population Health

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AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS