In late 2016, the Centers for Medicare and Medicaid Services (CMS) published a final ruling on Medicare Access and CHIP Reauthorization Act (MACRA) implementation. The act, signed into law in 2015, represents a shift in health care payments away from volume-based pay and toward value-based pay reimbursement. Despite a 2017 launch date, the fifth annual Health IT Industry Outlook Survey Stoltenberg Consulting recently published indicates that well over half of affected providers are unprepared for the change.
Insights from the Study
If your medical practice is behind in its MACRA transition efforts, you’re not alone. Some of the key insights from the study may help you kick-start compliance efforts. The consulting group gathered survey results at the annual HIMSS17 conference in Florida; professionals and executives accounted for the majority of responses. Findings include:
- 68% of the respondents consider MACRA implementation an interdepartmental challenge. To make the necessary changes, financial, IT, and clinical personnel must come together to address payment pathways and record keeping/management practices.
- Almost a third of respondents cited data creation and management as a top compliance concern, while 29% cited collaboration among departments as a top challenge.
- 64% of the group claimed they were either unprepared or very unprepared for MACRA changes.
These survey results represent alarming trends in MACRA planning and implementation. Affected health care facilities have the 2017 year as a transition period, but what happens today will affect physician reimbursement in 2019. Practices that fail to report for a single patient on one quality assurance measure, one activity for improvement, or ACI base measures during the year will incur a penalty in two years. Practices can also take steps today to receive positive payment adjustments.
How to Prepare for the Changes
Organizations concerned about MACRA penalty avoidance and financial planning can take the following steps to fully transition during the 2017 year:
- Perform a self-audit. The American Medical Association offers a payment model evaluator module designed to help practices identify their current level of compliance and make future changes.
- Collaborate with relevant departments. Create a focus group to take point on MACRA compliance activities. From record-keeping to quality improvement, create an executable plan and internal group to push the project forward.
- Evaluate alternative payment models. Work with your billing department and/or medical practice management company to optimize alternative payment models (APMs) and merit-based incentive payment systems (MIPS).
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MACRA planning and implementation today will provide peace of mind tomorrow. At Medical Business Management, we maintain awareness of the latest policies affecting the industry. If your MACRA plan affects your revenue cycle, we can help you optimize processes for improved compliance. Contact us today to learn more.