The health care transition from a fee-for-services model to a value-based model is underway. MACRA is the largest legal impetus for this transition, however most providers do not like MACRA and have little knowledge about it. In fact, a recent survey suggests that it could potentially have harmful effects on provider engagement.
Physician burnout is at an all-time high and some blame it on ACA, under which MACRA lives. Regardless, though, MACRA is here to stay. The full implementation may take years, but the path of least resistance may be to embrace it. Soon, we will see more private insurance companies following suit. Thankfully, though, the first year has been intentionally set up so that providers can proceed at their own pace.
Who MACRA Applies to
The vast majority of providers fall under MACRA. As long as you see more than 100 Medicare B patients or bill greater than $30,000 to Medicare B, MACRA applies to you.
The stakes will get high as the years progress. This year, the maximum penalty is 4% but will rise to as high as 7% in 2019. The penalties will add up. So, making the investment now will pay off in the future.
How to Meet MACRA’s Minimum Requirements
Participating in the first year to get a neutral payment adjustment is fairly simple. The ultimate goal of MACRA is to get everyone engaged. It is for this reason that the minimum requirement for the first year is set very low. You can fulfill the requirement by either reporting one quality measure OR one improvement activity OR by participating in Advancing Care Information (ACI). Minimum participation requires doing one of those three. That means that by reporting on quality improvement measure for one patient, you will get a neutral adjustment. ACI is what was previously known as Meaningful Use. If you have previously participated in Meaningful Use successfully, then continuing to participate will help you meet the minimum requirement.
Doing the minimum will help you avoid the penalty. The data that CMS will be collecting will, in part, be publically available on Physician Compare. However, patients already, and will increasingly, rely more on online profiles to choose their physician. The more daunting task is to start participating. Once you have started to participate in MACRA, maximizing your score is easier than you think. We have optimized our product suite to address key aspects of your MACRA performance to maximize your score.
How to Maximize Your Score
We created a series of blog posts to introduce you to 3 key ways to increase your MACRA performance and maximize your score:
Interested in finding out more? Contact our team today to set up a free demo and find out how we can help your practice maximize your MACRA performance and score.
Tashfeen Ekram, MD, is a radiologist, self-taught coder, healthcare innovator and Co-Founder of Luma Health. Contact him on Twitter at @tashfeenekramMD.