MACRA, MIPS, and Technology?

blog-macra-mipsMACRA! MIPS! Many healthcare organizations are feeling confused, overwhelmed, and concerned about the operational and financial impacts of the proposed 2017 value-based performance period. What does technology have anything to do with new rules and payment models?

MACRA and MIPS will challenge many healthcare organizations, however it also provides significant opportunity. Well-prepared organizations could see a 25% increase in Medicare payments. And 2019 reimbursement may exceed 100% based on 2017 performance. CMS estimates MIPS reporting to cost about $723 per clinician per year, and utilize about 11 hours of administrative time per reporting category per year. To keep costs down, healthcare organizations must understand that technology is critical to success under MACRA – especially for smaller practices.

MACRA focuses heavily on the use to technology to report on patient outcomes and interoperability. While traditional PQRS and Meaningful Use will still exist in various forms within MACRA, the focus will shift to accountable care and value-based reimbursement.

In addition to selecting quality measures to report, healthcare organizations must utilize existing technologies which support reliable, accurate, and cost-effective quality reporting. Verifying that your organization’s reporting tools of choice support the selected quality measures now is an important first step. Most systems will not support full reporting against the entire list of approximately 300 quality measures.

Looking ahead beyond the 2017 performance period, healthcare organizations must consider how they will continue MACRA compliance over the long term. It will be important to maintain compliance while not overburdening administrative and clinical staff with tedious planning, reporting, and quality assurance in future years. Aligning MACRA strategy, which is focused on traditional Medicare, with Medicaid and commercial payers is also an important step.

One final thought: MACRA remains simply proposed regulation. It will likely be changed and modified before a finalized version is approved. Healthcare organizations should continue seeking the latest information while preparing to comply with the new regulations.

Bringing together practice management, revenue cycle management, and electronic medical record is key. Prepare early, and remember all reporting metrics and performances will be publicly reported on the Medicare Physician Compare website.

UPDATE: CMS released the finalized rule for MACRA and Quality Payment Program (QPP) on October 14, 2016. Please check the new QPP/MACRA website provided by CMS here for more information.