MACRA: Are You Ready?
The impact of the Medicare Access and CHIP Reauthorization Act (MACRA) on the healthcare delivery system promises to be profound, yet some data suggest that greater than 90% of clinicians are ill prepared. MACRA’s Quality Payment Program dramatically changes the way we pay for healthcare, moving incentives from individual patient and procedural volume to population health and “value”. The newly established pathways for clinicians to participate this Quality Payment Program include:
1. The Merit-Based Incentive Payment System (MIPS) and
2. Alternative Payment Models (APMs).
Most clinicians who are not members of Accountable Care Organizations or Medicare demonstration projects will default into the MIPS pathway starting in 2019. MIPS eligible clinicians include physicians, PAs, NPs, Clinical Nurse Specialists, and Certified Registered Nurse Anesthetists. In the future, eligibility may expand to include other clinical groups such as physical and occupational therapists, midwives, and others. The MIPS composite score will include 4 weighted performance categories on a 0 – 100 point scale. The performance categories include:
2. Resource Utilization
3. Clinical Practice Improvement Activities
4. Advancing Care Information
Are You Ready?
The best way to self assess would be to ask yourself the following questions:
1. Am I successful in the current PQRS, Meaningful Use and Value Modifier programs?
2. Is my organization a part of an alternative payment model?
3. What does my cost and quality data look like?
4. What are the gaps in my clinical documentation?
Keep in mind that January 1, 2017 begins the first MIPS performance year, which will impact reimbursement in 2019. With the final rules anticipated November 1st, the time to begin preparing is now!
To learn more about MACRA and how reimbursement will increasingly be tied to quality of care, join us October 6th on the Columbia University Medical Center campus for our annual Network Day Event ~ details at http://columbiaheartsource.org/annual-network-day