title: Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.
abstract: As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists.
authors.affiliation: Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: john.barbieri@uphs.upenn.edu.
authors.forename: John S
authors.initials: JS
authors.lastname: Barbieri
authors.affiliation: Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Miller
authors.affiliation: Yale University, New Haven, Connecticut; Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Harrison P
authors.initials: HP
authors.lastname: Nguyen
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Howard P
authors.initials: HP
authors.lastname: Forman
authors.affiliation: Yale University, New Haven, Connecticut; Department of Public Health (Health Policy), Economics, and Management, Yale University, New Haven, Connecticut.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Bolognia
authors.affiliation: Department of Dermatology, University of Iowa (Carver) College of Medicine, Iowa City, Iowa.
authors.forename: Marta J
authors.initials: MJ
authors.lastname: VanBeek
mesh_terms: D002648:Child; D003880:Dermatology / Q000639:trends*; D005544:Forecasting; D006801:Humans; D000072641:Medicare Access and CHIP Reauthorization Act of 2015; D010816:Physician Incentive Plans; D012052:Reimbursement, Incentive; D014481:United States
keywords: Alternative Payment Model; Medicare Access and Children's Health Insurance Program Reauthorization Act; Merit-based Incentive Payment System; Sustainable Growth Rate; dermatology; health care reform; health policy; payment reform; small practices