Since going into effect on January 1, 2017, MACRA has been a topic of interest in the healthcare field. MACRA, or, the Medicare Access and CHIP Reauthorization Act, is a set of requirements from CMS (Centers for Medicare and Medicaid Services) that is designed to move healthcare for Medicare patients from volume to value through new weights and measures. The goal is to reward providers for giving better care to their patients, but many healthcare facilities are unaware of the new rules – which can lead to organizations being hit with negative payments, and can result in reductions to their medicare reimbursements from CMS.
Is your organization ready for MACRA? In today’s blog post, we go over three questions that you should know the answers to when it comes to MACRA preparedness and readiness.
1) Do You Know What MACRA Is?
Are you aware of what MACRA is? According to a Deloitte study from July, 2016, only about 50% of physicians had even heard of MACRA. It is important to become familiar with it, however, as it could have a negative financial impact on organizations who are not prepared for it. Knowing whether or not your EHR is performing as needed for MACRA – making sure it is in compliance with the new rules for measurement and reporting, and having an understanding of the technology and systems you will use to file your measures – will also be critical to MACRA compliance.
Do you see Medicare patients in your practice? Have you been filing under the old CMS reimbursement rules? Do you know what filing choices you have, and which ones are best for you? Do you know how the filing will be done? These are all questions that go hand-in-hand when learning what MACRA will mean for you, and ones that you must be able to answer in order to understand how it will affect your organization.
2) Do You Have Anyone Focused on Understanding What MACRA Will Mean for You?
The CMS has instituted a Quality Payment Program that has two tracks in which you can choose from: The Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Models (APMs). These will replace the Sustainable Growth Rate formula, and will provide new tools, models, and resources to help give your patients the best possible care. In addition, the CMS has also instituted a Quality Measure Development Plan (MDP) as a focused framework to help build and improve quality measures for clinicians.
The Deloitte survey from July, 2016 also found that 74% of surveyed physicians believe that performance reporting is burdensome, so many organizations will need to put resources and focus on these new rules. Do you know what track is most ideal for your organization, or how the MDP will affect you specifically? It may be necessary to bring in a team who can assess your healthcare facility, and work through what MACRA means for you.
MACRA is bringing many changes to healthcare organizations, and it will be necessary to be aware of the new rules, as well as what they should be doing to comply with them. Having a team focused on the implications of MACRA on your organization, as well as one that can educate your staff and clinicians on MACRA, will be greatly beneficial. Not only will this contribute to a more smooth transition into MACRA compliance, it will also help your organization maximize its CMS reimbursement.
3) Do You Know Which Measures You Will Be Using to File Under MACRA?
One thing that many organizations are not aware of when it comes to MACRA is the fact that they have a choice in which measures to use in certain categories. Has your organization selected which measures it will use? It may be in your best interest to select ones that you can make progress on improving, which may mean you need to bring in resources focused on improvement. There may be a bit of financial impact associated with improving measures, so make sure you understand how profound the associated costs will be, as well as how it will ultimately benefit your organization down the road.
If you don’t have a firm answer to any of the questions above, now is the time to start finding solutions. MACRA has arrived, and an unawareness of what it will inevitably mean for your organization can potentially lead to financial penalties. Make sure to consider all of the aspects that MACRA is going to change, and don’t be afraid to bring in outside resources to help you understand what your organization must do to adapt.
For further information on what MACRA will mean for your unique organization, make sure to contact us. We will work with you to develop a customized plan that works for your organization and will maximize your MACRA success.