Despite the change in
administration, experts say The Medicare Access and CHIP Reauthorization Act (MACRA)
is here to stay and it's full speed ahead. The MACRA law replaces the previous
fee-for-service Medicare payment structure with a value-based
pay-for-performance program built on measures of quality and efficiency. The
legislation affects all healthcare providers that care for at least 100
Medicare patients or bill more than $30,000 a year. The shift from volume to value-based
payment will either reward or penalize providers based upon their performance.
Although the program
has now been underway since January 2017, a recent survey indicates that more
than half of healthcare providers (64%) still feel they are unprepared to meet
the new requirements of the law. (1) The
positive news is that providers have the ability to pick their pace, which
allows for some flexibility, transitional time, and helps practices avoid
Below are some key
points practices should consider for MACRA success:
- Pick your team- All healthcare systems and medical groups
should identify a team of key leaders to head the MACRA transition.
- Register with CMS- The deadline for groups to register with
CMS is no later than June 30, 2017.
- Educate Staff- Meaningful and ongoing education is
necessary for all staff members. MACRA training should be tailored toward each
department to address varying concerns. Education tools may also be helpful
such as e-learning courses. Making education convenient and accessible is key
to adoption. (3)
- Report data- The
Centers for Medicaid and Medicare Services (CMS) requires eligible clinicians
to report on three performance categories for a consecutive 90-day period. Although,
it is important to track data the entire year, it is only necessary to submit
data for a 90-day period in order to receive a potential positive adjustment. Providers
may also report just one measure to prevent the penalty. Doing nothing at all, will
result in a 4% reduction in 2019 payments. (2)
- Review current data and reporting methods- MACRA requires careful tracking and
reporting. Identify current vendors and consolidate reporting methods. CMS
encourages organizations to streamline their vendors to reduce the
administrative burden. Only one submission mechanism for each performance
category is permitted. (2)
- Make Patient Experience the Core Focus- Patients outcomes and experience should
remain the core focus.
success is a collective team effort within a practice or organization.
Management should build a team and work with clinicians to select right
measures that work best for their practice. Always keeping patients front and
center of the implementation is key to success.