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.