As expected, MACRA, which is the acronym for Medicare’s Quality Payment Program, continues to evolve. The latest changes that apply to the third performance year, CY 2019, of this program were released Nov 1, 2018. Among the changes Medicare:

• Eligible Clinicians category was modified to include:

o Physical therapists
o Occupational therapists
o Qualified speech-language pathologists
o Qualified audiologists
o Clinical psychologists
o Registered dietitian or nutritional professionals

• Weighted values have changed. There is a decrease in quality and an increase in costs.

• Exclusion Criteria. Medicare added one additional exclusion criteria to the two already existing. The current exclusion categories are:

≤ $90,000 in allowed Part B charges
≤ 200 Part B beneficiaries seen during the determination period
≤ 200 in allowed Part B professional services

• 2019 score will also affect 2012 fee schedule of eligible clinicians. For this year the pendulum will move 7%. In other words, a Practice that customary makes $400k per year may receive anywhere between $372k to 428k.

There are more changes to the 2019 Quality Program but the bottom-line remains as been an evolving process. To be truthful, Medicare’s goal is to reduce costs and improve patient outcomes. So, whether you participate in MACRA or not, be ready for new measures and quality initiatives.