MACRA is coming: Tips to prepare

Are you ready for MACRA? If not, you're not alone. According to the Deloitte Center for Health Solutions 2016 Survey of U.S. Physicians, 50 percent of physicians surveyed say they have never heard of the law, and 32 percent recognize it by name but are not familiar with its requirements.

Those responses are alarming, and mean providers are going to need help.

For those who do not know about MACRA: it is the Centers for Medicare & Medicaid Services (CMS) Medicare Access and CHIP Reauthorization Act of 2015. MACRA is a Medicare payment law intended to drive healthcare payment and delivery system reform for clinicians, health systems, Medicare, and other government and commercial payers. MACRA is intended to create a path toward a new Medicare payment system that will more closely align payment with quality and outcomes. It offers financial incentives for healthcare professionals to participate in risk-bearing, coordinated care models and moves away from the traditional fee-for-service system. Providers participating under the Medicare fee schedule will generally choose between participating in Alternative Payment Models (APMs) or receiving payment based on individual performance under the Merit-Based Incentive Payment System (MIPS).

Since quality is the primary driver under MACRA, providers will need to begin reporting quality measures through participation in either MIPS or APMs. Though many providers are concerned about MACRA, especially smaller practices that don't have the resources that may be required for MACRA, some good news arrived in September when the CMS announced that it is offering more flexibility for implementation. Providers can "Pick Your Pace" by selecting one of four tracks for 2017 implementation, with the understanding that participation at any level would avoid a negative adjustment.

As you look ahead at preparing for MACRA, a few tips to consider:
Leverage comparative data to create meaningful benchmarks to accurately prioritize business initiatives. Whichever model you choose, practices will likely see an impact in business operations. Comparative analytics can help bring together data – from payers, other providers and patients - to give management the ability to understand how your volume, claims and payment times compare to your peers, and how you can successfully deliver value, comparing quality and costs through utilization and outcome measurements and peer benchmarking.
Stay informed of what professional associations and others are doing to help providers. One example is the American Medical Association's recently introduced series of online tools designed to help providers transition to Medicare's new payment schemes under MACRA. In the AMA's STEPS Forward platform there are 42 modules, including those on selecting and implementing an EHR, reporting to data registries, and complying with the law's quality measures. The AMA also released a Payment Model Evaluator, which will help providers understand how MACRA will affect them and how best to succeed under the new law.

Bottom line: Staying apprised of all-things MACRA, taking advantage of tools, data and other information will help as you prepare your practice for this change.

Tara Williams Bio
Product Manager

Tara Williams comes to RemitDATA with 20 years of healthcare IT experience, specializing in software billing processes and solutions with an expertise in pharmacy and medical claims.

Tara elevates the value of products by successfully collaborating with product management, development and marketing teams – all leading to stronger software programs focused on improving medical claims billing processes and the outcomes.

Before joining RemitDATA in 2013, Tara led similar initiatives at Cooks Children's Health Care System and GE Healthcare.

Tara is a member of the North American Pool Tour and frequently travels across the U.S. to compete in pool tournaments.

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