What’s happened with MACRA in 2017: Tips for continued success with MIPS, CPC+, APMs and quality payment programs March 27, 2017
The Medicare Access and CHIP Reimbursement Act of 2015 (MACRA), also known as the Quality Payment Program (QPP), was launched almost 4 months ago today. The act, which changed the way providers who see Medicare patients receive reimbursements to a value-based model, is one of the biggest policy changes impacting independent physicians.
Even though MACRA is now underway, a recent survey indicated that 64% of healthcare providers feel that they are not ready to meet the reporting requirements of this new program.
The first step to partaking in MACRA for any independent physician should be to obtain a solid understanding of what the program entails and how physicians can prepare to participate. Here is our all-encompassing guide to MACRA as a start.
But for those that are more familiar with MACRA – what is new?
A report that studied an early review of MACRA’s implementation found two key findings that could play a significant role in the success of the program:
- Participating physicians need the appropriate help and technical assistance in order to get ready to participate in MACRA
- Health IT systems need to support MACRA participants by supporting the data reporting functionalities needed to properly report and receive payment adjustments
The authors of the report specifically pointed out solo and small practices, regarding the first point, noting that without sufficient support, physicians will struggle to meet MACRA’s reporting requirements. “Frustrated providers may even opt not to participate in the QPP despite the payment penalty, limiting the program’s ability to meet its goal,” the authors added.
From a more technical standpoint, as the authors noted, because physicians need to be able to accurately report on QPP data, technology providers play an even more critical first-hand role in ensuring the success of providers in this program.
But we believe that reporting for MACRA means more than just having a system that is MACRA-ready. Systems need to put a specific focus on making participating in MACRA as easy as possible so that physicians can devote most of their time and resources toward treating their patients.
Among the other concerns for MACRA are the potential changes to the program under the Trump Administration. As we detailed earlier, because MACRA was a bipartisan piece legislation, it’s unlikely that a new administration would implement large-scale changes to the program. Recently confirmed HHS Secretary, Dr. Tom Price, could even advocate for more flexibility for the program, as he previously advocated for softer Meaningful Use (MU) requirements.
Another issue revolving around the implementation of MACRA relates to the Centers for Medicare & Medicaid Services (CMS) exemption that practices with less than $30,000 in Medicare billings or fewer than 100 unique Medicare patients per year would not have to participate in MACRA. The agency had planned to formally notify physicians of their exemptions in December, but doctors have yet to receive these notifications.
According to a CMS spokesperson, the agency plans to send out the notifications sometime this spring. Elation will have formal exemption information available as soon as it is released.
Clearly, staying on course with MACRA can be challenging for both providers and CMS. The success of MACRA hinges on independent physicians, or those on the frontlines of providing patient-centered, value-based care. Supporting these physicians is a priority for Elation. We’ve created online resources, live webinars, informative videos, email newsletters, detailed articles, and on-call health policy specialists to give you specific guidance and support to help physicians navigate MACRA.
We’re committed to making the transition to value-based care as uncomplicated as possible for every type of practice – from those who have already begun participation to those who are beginning to take first steps – Elation is here as an ally and armed with resources to empower independent practices to participate stress-free.