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What is MACRA and What Does it Mean for Me?

Posted by The HCI Group on January 5, 2017 at 3:43 PM

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What is MACRA and What Does it Mean for Me?

With MACRA having recently gone into effect, organization’s should be prepared and equipped with an understanding of both what it is, as well as what it will mean for their unique health system. Without this information, healthcare facilities could stand to face several financial penalties.

In today’s blog post, HCIs Shaila Kapur goes over what MACRA is, as well as what it can mean for your healthcare organization.

1) What is MACRA?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the old formula, replacing a broken, frustrating, and needlessly unpredictable system. This transition stabilizes Medicare payments and has the potential to reward physicians for what they do best— providing quality, high-value care.  This change took effect on January 1, 2017, and will be the standard moving forward.

2) What Does it Mean for Physicians and Practices?

While it may seem like MACRA is obviously going to be beneficial, there are some physicians who believe it may become problematic. One reason for this, according to a Deloitte study from July, 2016, is due to the fact that only about half of the physicians surveyed had even heard of MACRA. Many physicians view themselves as healers, not business people, so the changes and complexity brought by the new regulations are not exactly welcome to them. 

While MACRA brings flexibility, choice, and greater stability in payments, the adoption of the regulations can be complex, burdensome, and time-consuming. Larger physician practices may have the resources and technology necessary to adopt the changes successfully, but for smaller practices, including those who were previously exempt from this reporting, it can be daunting.

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3) How to Make MACRA Work for You

So what can be done? Firstly, there is a lot of information available about the changes from various sources, and in most cases, paying attention to the key requirements and identifying top measures for improvement can have a big payoff. Secondly, making the changes quickly will, in many cases, improve practices’ effectiveness, efficiency and results – so the sooner changes get made, the greater the benefit. 

Most importantly, physicians with Medicare patients need to know what’s coming and take action quickly so they don’t suffer penalties. There are several complex formulas that MACRA will rely on to create a unique composite score for individual organizations, so it may be wise to reach out to third-party vendors to assist in helping your organization find out what MACRA will mean for you, specifically.

MACRA is here to stay, so understanding what it means and reacting is going to be good for all involved. Becoming aware of how existing quality programs will change due to MACRA performance categories will be necessary in order to avoid any financial penalties.

For further information on what MACRA will mean for your unique organization, make sure to contact us.

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