AE March/April 2018 Vol 27 No 2 - 25

Members can access category guides for
complete requirements, FAQs, top tips,
videos, podcasts, and more. Call the
MACRA Hotline at 703-383-5724 for
additional help.
final MIPS score of 15 to avoid
a penalty).
* Claim a significant hardship for
the Advancing Care Information
(ACI) category. The ACI category weight will be re-weighted to
Quality, for a total of 75% of the
final MIPS score.
* Continue to receive full credit
in the Improvement Activities
category by submitting one
high-weighted activity.
* Receive no fewer than 3 points
for any quality measure submitted, without having to meet
data completeness thresholds or
benchmarks.
ASCRS*ASOA has developed a
small practice fact sheet, available
on the ASCRS MACRA Center
website at ascrs.org/macracenter.
COST CATEGORY WEIGHT RAISED
TO 10%
Despite opposition from ASCRS
and the medical community,
CMS is weighting Cost as 10%
of the 2018 final MIPS score.
Some ophthalmic practices will be
affected; however, there is no way
to influence your score. Cost includes two problematic measures:
(1) Medicare spending per beneficiary and (2) total per capita cost
of care. The measures retain the
flawed attribution methodology
from the Value-Based Payment
modifier, which attributes a

patient first if they see a primary
care physician sometime in the
performance year, and if not, they
are attributed to whoever bills
the plurality of E/M services-
which could be an ophthalmology
practice. Practices may be held
accountable for the cost of care
they did not provide. In addition,
these measures are not adequately
risk-adjusted.
ASCRS continues to oppose
these measures and is supporting
efforts to develop more relevant
episode-based cost measures. The
episode measures tested in Fall
2017, including cataract surgery,
are still under development and
will not be included in the 2018
Cost category. No data submission is required for Cost; CMS
will calculate the score based on
claims. If your practice does not
have any attributed cost measures,
the 10% weight of the category
reverts to the Quality category.
IMPROVEMENT SCORING IN
THE QUALITY CATEGORY
As required by the MACRA statute, CMS is incorporating how
well a physician or group improves from one year to the next
in MIPS. For the Quality Category, CMS will compare physicians'
and groups' 2017 overall Quality
category scores to their 2018
Quality category scores and award

up to 10 points if the overall category score improves from one year
to the next. Improvement will not
be scored on an individual-measure basis.
MACRA TECHNICAL CORRECTIONS
Recently, Congress enacted several
technical corrections to the
MACRA statute advocated for by
ASCRS*ASOA. These changes include removing Part B drugs from
MIPS eligibility determinations
and payment adjustments; continuing the MIPS transition period
for 3 additional years before CMS
sets the performance threshold at
the mean or median of the previous year's scores; allowing CMS
to weight the Cost category at less
than 30% for 3 additional years;
and delaying Cost improvement
scoring until 2022.
ASCRS*ASOA RESOURCES
ASCRS*ASOA provides its
members with in-depth resources to succeed in MIPS. Visit the
ASCRS*ASOA MACRA center at
ascrs.org/macracenter for full details
on the 2018 changes mentioned
above. In addition, members can
access category guides for complete
requirements, FAQs, top tips, videos, podcasts, and more. Call the
MACRA Hotline at 703-383-5724
for additional help. AE
Allison Madson (703591-2220; amadson@
ascrs.org) is manager
of regulatory affairs at
ASCRS*ASOA,
Fairfax, Va.

www.asoa.org // AE

25


http://www.ascrs.org/macracenter http://www.ascrs.org/macracenter http://www.asoa.org

Table of Contents for the Digital Edition of AE March/April 2018 Vol 27 No 2

How We Can Successfully Lead
Advanced Administration: Administrator Success Factors—Needing a Tune-Up Is Expected
Advice for New Administrators: Introducing the Administrator Beginners Circle—The Go-To Resource for New Administrators
Business Operations: Some Things to Know About Professional Liability Insurance
Customer Care: Making a Diffi cult Journey A Little Easier
Fast Practice: Breaking Down Practice Cliques
Human Resources: Recruiting Strategies for Ophthalmology—Where to Search for New Physicians
InfoTech: Cloud Computing— Storms or Blue Skies?
Reimbursement: Embracing Change to Thrive in an Evolving Reimbursement World
Technicians: Creating a “Feeder Program” to Staff Your Clinic
Washington Watch: MIPS in 2018—Key Changes for Ophthalmic Practices
Taking Your Practice to the Top
Use Podcasts to Increase Practice Visibility—and Thrive
Trailblazing— How to Implement Career Pathing in Your Practice
Ocular Surface Disease: Reimbursement Considerations for the Evaluation and Management of Dry Eye
Retina: Should Retinal Specialists Be Integrated Into a Multispecialty Practice?
Asked and Answered
ASOA News
Bookshelf: Off Balance On Purpose: Embrace Uncertainty and Create a Life You Love
COE Corner: Preparing for the COE Exam – Keep Your Eye on the Prize
Focus on a Practice: Ohio Valley Eye Physicians & Surgeons, PLLC, on Operating a Practice in Two States
Gamechanger: Karen Bachman, COE, COMT, OCS, ROUB
Advertisers’ Index
Peer to Peer: What’s Your Favorite Technique for Holding a Productive Staff Meeting?
AE March/April 2018 Vol 27 No 2 - Cover1
AE March/April 2018 Vol 27 No 2 - Cover2
AE March/April 2018 Vol 27 No 2 - 1
AE March/April 2018 Vol 27 No 2 - 2
AE March/April 2018 Vol 27 No 2 - 3
AE March/April 2018 Vol 27 No 2 - 4
AE March/April 2018 Vol 27 No 2 - How We Can Successfully Lead
AE March/April 2018 Vol 27 No 2 - Advanced Administration: Administrator Success Factors—Needing a Tune-Up Is Expected
AE March/April 2018 Vol 27 No 2 - 7
AE March/April 2018 Vol 27 No 2 - Advice for New Administrators: Introducing the Administrator Beginners Circle—The Go-To Resource for New Administrators
AE March/April 2018 Vol 27 No 2 - 9
AE March/April 2018 Vol 27 No 2 - Business Operations: Some Things to Know About Professional Liability Insurance
AE March/April 2018 Vol 27 No 2 - 11
AE March/April 2018 Vol 27 No 2 - Customer Care: Making a Diffi cult Journey A Little Easier
AE March/April 2018 Vol 27 No 2 - 13
AE March/April 2018 Vol 27 No 2 - Fast Practice: Breaking Down Practice Cliques
AE March/April 2018 Vol 27 No 2 - 15
AE March/April 2018 Vol 27 No 2 - Human Resources: Recruiting Strategies for Ophthalmology—Where to Search for New Physicians
AE March/April 2018 Vol 27 No 2 - 17
AE March/April 2018 Vol 27 No 2 - InfoTech: Cloud Computing— Storms or Blue Skies?
AE March/April 2018 Vol 27 No 2 - 19
AE March/April 2018 Vol 27 No 2 - Reimbursement: Embracing Change to Thrive in an Evolving Reimbursement World
AE March/April 2018 Vol 27 No 2 - 21
AE March/April 2018 Vol 27 No 2 - Technicians: Creating a “Feeder Program” to Staff Your Clinic
AE March/April 2018 Vol 27 No 2 - 23
AE March/April 2018 Vol 27 No 2 - Washington Watch: MIPS in 2018—Key Changes for Ophthalmic Practices
AE March/April 2018 Vol 27 No 2 - 25
AE March/April 2018 Vol 27 No 2 - Taking Your Practice to the Top
AE March/April 2018 Vol 27 No 2 - 27
AE March/April 2018 Vol 27 No 2 - 28
AE March/April 2018 Vol 27 No 2 - 29
AE March/April 2018 Vol 27 No 2 - 30
AE March/April 2018 Vol 27 No 2 - 31
AE March/April 2018 Vol 27 No 2 - 32
AE March/April 2018 Vol 27 No 2 - 33
AE March/April 2018 Vol 27 No 2 - Use Podcasts to Increase Practice Visibility—and Thrive
AE March/April 2018 Vol 27 No 2 - 35
AE March/April 2018 Vol 27 No 2 - 36
AE March/April 2018 Vol 27 No 2 - 37
AE March/April 2018 Vol 27 No 2 - Trailblazing— How to Implement Career Pathing in Your Practice
AE March/April 2018 Vol 27 No 2 - 39
AE March/April 2018 Vol 27 No 2 - 40
AE March/April 2018 Vol 27 No 2 - 41
AE March/April 2018 Vol 27 No 2 - Ocular Surface Disease: Reimbursement Considerations for the Evaluation and Management of Dry Eye
AE March/April 2018 Vol 27 No 2 - 43
AE March/April 2018 Vol 27 No 2 - Retina: Should Retinal Specialists Be Integrated Into a Multispecialty Practice?
AE March/April 2018 Vol 27 No 2 - 45
AE March/April 2018 Vol 27 No 2 - Asked and Answered
AE March/April 2018 Vol 27 No 2 - 47
AE March/April 2018 Vol 27 No 2 - ASOA News
AE March/April 2018 Vol 27 No 2 - 49
AE March/April 2018 Vol 27 No 2 - Bookshelf: Off Balance On Purpose: Embrace Uncertainty and Create a Life You Love
AE March/April 2018 Vol 27 No 2 - 51
AE March/April 2018 Vol 27 No 2 - COE Corner: Preparing for the COE Exam – Keep Your Eye on the Prize
AE March/April 2018 Vol 27 No 2 - 53
AE March/April 2018 Vol 27 No 2 - Focus on a Practice: Ohio Valley Eye Physicians & Surgeons, PLLC, on Operating a Practice in Two States
AE March/April 2018 Vol 27 No 2 - 55
AE March/April 2018 Vol 27 No 2 - Gamechanger: Karen Bachman, COE, COMT, OCS, ROUB
AE March/April 2018 Vol 27 No 2 - 57
AE March/April 2018 Vol 27 No 2 - Advertisers’ Index
AE March/April 2018 Vol 27 No 2 - 59
AE March/April 2018 Vol 27 No 2 - Peer to Peer: What’s Your Favorite Technique for Holding a Productive Staff Meeting?
AE March/April 2018 Vol 27 No 2 - Cover3
AE March/April 2018 Vol 27 No 2 - Cover4
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