Category Archives: MACRA

MACRA is not the Macarena But It Is A Dance You Can Learn

The Medicare Access and CHIP Reauthorization Act of 2015, also known as MACRA, is on the minds of physicians and practice managers from coast to coast. As with any new ruling from CMS, the challenge is to fully understand the changes to the law and what it means for your practice. Change is never easy, but this change has to be met head-on, or the clinic’s bottom line may suffer.

To help address your questions about MACRA, GE Healthcare is hosting a webinar called “MIPS, MACRA and YOU in 2018” on Monday, November 27th from 9:00 a.m. to 10:00 a.m. Pacific Time. The webinar will feature Mark Segal and Donna Maddox from GE Healthcare, and David Swartout from Mountain View Medical in Forest Grove and Hillsboro, Oregon.

While MACRA presents a host of new challenges for clinics, Donna Daniel of IBW Watson Health argues that managing and analyzing patient data is the core function that clinics must learn to master.

Provider performance will be measured against national peer performance to establish goals, incentives, and payment structure. Organizations that perform well against the quality benchmarks while controlling costs will be financially rewarded. Those who miss the mark may see their Medicare reimbursements shrink. This puts a great deal of pressure on providers to immerse themselves in performance metrics.

We all know that practicing medicine has plenty of its own pressures. Know that you can lean on HealthCo and GE Healthcare to help you manage MACRA/MIPS.

Understanding Merit-based Incentive Payment System (MIPS)

MIPS replaced the Physician Quality Reporting System, Value-Based Modifier, and Meaningful Use of electronic health records programs. It also added a fourth component, Improvement Activities, which is intended to give physicians credit for their efforts to reduce disparities in care, engage patients in shared decision-making, and other activities designed to improve care.

Instead of three separate programs, MIPS is designed to be one cohesive program with a single score for each physician or group. The score will be derived from four components: quality, costs, improvement activities, and advancing care information.

Sandy Marks, Assistant Director of Federal Affairs at the American Medical Association, notes that MIPS presents a variety of special challenges for small and rural practices.

When Congress enacted MACRA, it recognized the unique challenges facing physicians in small and rural practices. For example, the law required CMS to set a low-volume threshold so that physicians who do not treat enough Medicare patients to have a chance at getting a positive return from participating in MIPS would be exempt from it. MACRA also called for creating virtual groups so that physicians in small and rural practices can combine their resources to jointly report on MIPS measures.

Get A Firm Grip On 2017 MIPS Reporting

Under MIPS, each clinician will be measured against four categories: quality, cost, improvement activities and advancing care information. Quality is the most important category right now, as it accounts for 60% of the clinician’s overall score. Each clinician under the MIPS program receives a final score (from 1 to 100) and that number determines the amount of payment the clinician is eligible to receive in 2019.

If you’d like to learn more about these four reporting categories, CMS has excellent “explainer” videos on the topic available.

Our dedicated team of Centricity Practice Solution specialists is also available to walk you through any specific MACRA- or MIPS-related questions.

It’s Conference Season and We’re Headed To Bend, Boise, and New Orleans

Bend, Oregon is a favorite destination for golfers, mountain sports enthusiasts, and people in search of the sun. This week, The Riverhouse in Bend will also host hundreds of practice administrators from around the state at the annual Oregon MGMA Conference.

Some of the key sessions we’re looking forward to:

  • Benchmarking Your Key Performance Indicators
  • MACRA – State of Affairs and Updates

HealthCo will also have a booth on the exhibitor floor at the Riverhouse. Please stop by Booth #501 and say hello. We are also giving away three fully loaded gift baskets!

Directly on the heels of Oregon MGMA in Bend, the HealthCo team heads to Boise for Idaho’s annual MGMA Conference. The Idahoans are always great hosts and this year is no exception. The event kicks off with a golf tournament at Warm Spring Golf Course. Whether you’re an expert golfer or have never played, come and enjoy a morning of fun, prizes, contests, and the excellent company of your peers.

When we get down to business in Boise, there will be incredible programming available. In fact, all three of these of the following presentations are in the same time slot (forcing one to make a tough choice):

  • Good Clinics to Great Clinics
  • Mentoring: The Key to Professional Development
  • Engaging Physicians

After returning from these key annual pilgrimages, we will begin to prepare for CHUG Fall 2017, which is in New Orleans this October.

I sense beignets in our future.

The keynote speaker at CHUG is Dr. Kavita Patel, a co-founder of Tuple Health, a physician-led company focused on practical clinical solutions to bring care back to health. Dr. Patel was previously a Director of Policy for The White House under President Obama and a senior adviser to the late Senator Edward Kennedy.

We’re always interested in seeing our customers at these key industry events, and hearing from industry leaders about important topics in healthcare IT and practice management. If you’d like to schedule a time to chat during these upcoming events, let’s do so now.

How To Meet the Needs of CMS’ New Quality Payment Program

If your clinic participates in Medicare Part B, you are part of the dedicated team of clinicians who serve more than 55 million of the country’s most vulnerable Americans.

The new Quality Payment Program (QPP) from Centers for Medicare and Medicaid (first announced as “MACRA” in January 2015) provides new tools and resources to help you give your patients the best possible care. The Quality Payment Program achieves the following:

  • Repeals the Sustainable Growth (SGR) Formula
  • Streamlines multiple quality reporting programs into the new Merit-based Incentive Payment System (MIPS)
  • Provides incentive payments for participation in Advanced Alternative Payment Models (APMs)

What does this mean for your practice? It means adopting new policies and practices to help you monitor and care for patients at a group level. Like any change, QPP requires both business and clinical leadership to state the goals and achieve them.

Don’t let this new program sneak up and surprise you. In these first weeks of 2017, HealthCo team members have been speaking with our partners in clinics that are now starting to see their first penalties associated with abstaining from Meaningful Use programs, and some are shocked at the adjustments. Thankfully, the HealthCo team is ready to answer your questions and help you adjust workflows, as needed. There are also great resources to help you navigate QPP, including this New White Paper from GE Healthcare.

5-Answers-To-Your-Most-Important-MACRA-Questions-White-Paper-01192017-JB4608845_pdf

In lieu of a future deep dive into the topic, we have a few quick tips to get you started:

  • Determine which providers are eligible: Research the rules to make certain you understand which of your providers meet the criteria to participate in QPP.
  • Assess how quickly you want to move: CMS has given you several options for participation from submitting nothing to submitting partial or full-year data.
  • Assess group or individual participation: When reporting as a group there are additional methods for reporting on Quality and Advancing Care measures, so make sure you are clear on your clinic’s reporting status.

Wading through white papers on legislative changes can be time-consuming and dense reading. Remember, we are just a phone call away. Our team of rock star trainers can walk you through the all the various QPP steps and get you heading in the right direction.