Are you overwhelmed by the detailed requirements of the Medicare Access and CHIP Reauthorization Act (MACRA)? If yes, your practice is not alone.
According to Pa.-based Stoltenberg Consulting's fifth-annual Health IT Industry Outlook Survey, 64 percent of providers say they feel "unprepared" or "very unprepared" for managing and executing MACRA initiatives.
MACRA holds major significance for these confused providers because its Quality Payment Program (QPP) centers on improved patient outcomes, activities for quality clinical care practices, efficient use of medical resources, and the meaningful utilization of EHRs. The QPP replaces the outdated Sustainable Growth Rate (SGR) formula, moving away from fee-for-service care.
Now practices are tasked with the job of thinking beyond claims data in the transition to value-based care and eliminating the data-silo mentality. This represents a major upheaval for many, and a challenge for all.
But while 68 percent of survey respondents said preparation for MACRA should be a combined effort with clinical, financial and IT departments working cohesively, pulling together the right mix of representatives is not always easy. In fact, 82 percent of survey respondents admitted that finding qualified health IT representation is an obstacle.
Considering the ongoing reporting burden, reimbursement impact, and industry significance tied into MACRA's QPP, lack of readiness is widespread across already stretched physician practices. Many still struggle to understand the program altogether, assumed it would be delayed or hindered by a repeal of the Affordable Care Act (ACA) or don't know how to jump-start reporting alignment. To overcome physician practices' already limited resources, consider the following four tips for making the most of MACRA:
•Set the groundwork. Establish a working MACRA governance committee with cross-departmental representation. Financial representation can take the lead in selecting reporting measures for the practice under the Merit-based Incentive Payment System (MIPS) that will be most operationally effective among the varied options laid out by CMS. For a solid foundation, the team needs to absorb a strong understanding of MACRA to effectively identify reporting gaps. Resources like this MIPS participation factsheet cover program exemptions, participant expectations and guidelines.
Even within physician practices where there isn't a designated IT department, it's important to bring in the voice of the individual who best knows how to maintain, extract and analyze practice data. The go-to IT expert needs to work with financial and clinical representatives to help the practice achieve success under MACRA. If you can’t pinpoint that voice, it may be time to bring in a third-party IT advisor, who can assess and capture the whole picture of care by best maneuvering the EHR system.