Driving Revenue Performance – Value-Based Payments & MACRA Made Easy

The transition to Value-Based Payments is a reality and MACRA is not going anywhere!  

MACRA is a separate legislation from ACA and was passed with bipartisan support. This means too many GOP votes behind it to repeal. The question is “can it be improved or be modified?” Of course, the answer is yes and more so now that the GOP Doctors Caucus is monitoring how the MACRA implementation is coming along. As a Medicare participant, your voice matters when it comes to regulations and MACRA can be fine-tuned so the patient and your private practice are the main beneficiaries and not the government. If MACRA is too complicated, small practices will stop accepting Medicare and lose those patients and revenue.

The GOP Doctors Caucus must continue to watch the roll out of MACRA, listen to small private practices, and work with Dr. Price and the Trump administration on improving it.

How you implement MACRA can impact your revenue and your practice’s reputation

If you choose to do nothing in 2017, you must have a plan for 2018 and a reasonable explanation for when patients search the internet and end up at CMS’ Physician Compare website. By the same token, a half-baked MACRA implementation that yields poor performance scores will do as much damage, not to mention the loss of revenue in penalties. To learn more about your Quality performance score and your public online reputation visit the “Physician Compare” website and click on the “Improving Healthcare Quality” button.

MACRA is new to all of us and it is complex; however, knowing the key steps to get started is critical. CMS puts out many training webinars on MACRA, but who has the time? … The purpose of these blogs is to disseminate all that information into simple and to the point postings to help you make decisions for the benefit of your patients and your practice.

Once considered the “death knell” for small practices, this is no longer the case. Implementing MACRA is relatively easy. In a recent “deep dive” webinar on MIPS, CMS showed how much they have relaxed the requirements of one of the most challenging components, making it very easy to achieve compliance with MACRA in 2017. Maybe the Meaningful Use roll out fiasco a few years back has put CMS under the scope and they don’t want a repeat.

Sample MACRA Implementation guidelines

This sample guidelines will help you develop your plan for best performance scores and protection of your on-line reputation, however it is not a full set but it’ll get you started:

  • Understand the MACRA requirements for your practice and specialty.
  • Know which track to select (MIPS or APM)
  • Ensure your EHR truly meets MACRA requirements
  • Determine your Clinical, Operational, Financial, Technology and Security objectives
  • Identify training and support required by all staff
  • Establish the reporting period, set a Go-live date and a timeline.
  • Establish Milestones and performance score checkpoints (This is key to meet the 2017 reporting)
  • Develop plan for 2018

Value-Based Payments and MACRA open the door to new revenue streams … Stay tuned!

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