Truth About MACRA

October 21, 2016


MACRA is designed to reduce the administrative burden for providers in the move from fee-for-service to value based healthcare. 2400 pages of detail was published in the final rule on October 14th, here are the basics:

  • Who: physicians, physician assistants, and nurses that bill Medicare are eligible to participate in MACRA
  • What: move from F4S to value based care 
  • When: kicks off Jan 1, 2017 with impact to payments showing up in 2019
  • How: MACRA contains 2 tracks - MIPS & aAPMs Eligible providers must PARTICIPATE or prepare for a 4% MEDICARE PENALTY in 2019. 

It is easy to get lost in the detail of a 2400 page regulation. In fact, published commentary already total more than 2m results in today's Google search. That number is likely to explode before we finish implementing MACRA. 

So let's take a pause... to ponder the broader strategy in an attempt to determine what is required to be successful in this transition. Consider the following items as you develop your strategy:

  1. MACRA is NOT an isolated program 

MACRA fits into a broader CMS Strategy aimed to align medical practices with the transitions already underway in hospital and ancillary care. This is a topic worthy of its own posting; stay tuned for future posting. 

Key Point: Transitions are happening across the continuum of care making care coordination, real-time data sharing, and patient engagement more important than ever.

2. MACRA is NOT a technology task

Success will not be found by only ticking-the-boxes associated with technology requirements. 

A certified EMR is the foundation. Additional capability development is required and includes efficient clinical documentation capture, data analytics for reporting and continual improvement. Implementation of these capabilities requires awareness arising, consensus building, and process adjustments all wrapped in a repeatable framework.

3. MACRA is NOT business as usual

Sustainable success requires a business model transition

Medical practices operating in Fee-For-Service must transition to utilizing the value-based healthcare framework. This new business model will be required to meet and sustain improvement thresholds. Success hinges on an organizations ability to utilize technology-enabled analytics, improve clinical quality & outcomes, and reduce costs. 

Have you developed your MACRA strategy? Does it include a value-based healthcare framework? 

Click HERE for MACRA video.

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