MACRA June 2017 Update

To this date we still find Healthcare Professionals who are not aware of MACRA or their responsibilities under the same. Also, we find that multispecialty independent groups are having difficulty keeping some of their “team members” up to par with their responsibilities.

Here is the scoop, MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. MACRA was designed to eliminate the Sustainable Growth Formula (SGR) and to merge a number of quality/reporting Medicare programs. In other words, MACRA is a compliance law combined with reimbursement options.

Overall Healthcare Providers have two tracks to choose from: the Advanced Payment Models (APM) and the Merit Based Incentive Program (MIPS). Under the MIPS there are four components: Quality Reporting, Advancing Care Information, Resource Use and Clinical Practice Improvement Activities.

From there it gets a little more complex as there are several choices to use and depending on the choices and the category is how the scoring will take place. Regardless of the complexity and the need to look at these choices on a case by case basis there are a few recommendations we can provide that should help just about everyone affected by MACRA.

  1. Complete a yearly HIPAA (Health Insurance Portability and Accountability Act) Security Risk Analysis (SRA). Ideally have an outside agency perform the SRA.
  2. Protect Patient Information. This is basically the implementation of Policies and Procedures and training based on HIPAA Security.
  3. Become proficient in the technology (hardware and software) needed to report data to CMS (Centers for Medicare and Medicaid Services).
  4. Be careful if working with other Practices as you will get an overall score which will determine your payment adjustment and the ability to get a bonus.
  5. Be proactive and get professional assistance.

MACRA is not easy and there is no one template that will work with everyone so make sure you act now.