• linkedin
  • Increase Font
  • Sharebar

    5 key factors in considering MACRA virtual groups

    Changes resulting from CMS’ Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have created new opportunities for practices to evolve how they manage payment and reimbursement. One example is that solo practitioners and small practices will be eligible to join a virtual group to report their Quality Payment Program (QPP) measures for the first time.


    RELATED READING: MACRA will not save money


    While not limited on the number of participants, the virtual group is defined as a combination of two or more Taxpayer Identification Numbers (TINs) assigned to one or more solo practitioners, or to one or more groups consisting of 10 or fewer clinicians (including at least 1 Merit-based Incentive Payments System (MIPS) eligible clinician), or both, that elect to voluntarily form a virtual group for a performance period for a year. There are also no restrictions based on location or specialty.Jackie Rodgers

    While a virtual group is not for everyone, clinicians or TINs that join may find it easier to be successful in reporting their quality metrics under the Quality Payment Program, thus earning a potential for greater reimbursement (ranging from 5 percent in 2018 up to 9 percent in 2020).

    Practices must weigh several factors before making a decision that could have significant impact on its performance under MIPS.

    Data Collection

    A key benefit of virtual groups is the ability for clinicians and practices to aggregate data together to report on performance measures. This may help clinicians who are struggling to show significant results by combining data with partners who have stronger results on key performance measures.

    However, virtual groups—just like regular groups—must report on all the same measures for the same period. When considering if a virtual group is a good fit, practices should factor in the measures that all participants have available and are applicable to them early in the process to maximize the strength of data available reported for the group: either through registry or EHR.

    Next: Partner reliability

    Jackie Rogers
    Jackie Rogers is the manager of the Quality Reporting Engagement Group at data analysis provider IntrinsiQ Specialty Solutions, a part ...


    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available

    Latest Tweets Follow