As of right now, providers are likely to have their payments adjusted in 2019 based on their performance in 2017, so preparing your practice for changes in reimbursement policies under MACRA is of utmost importance. You’ll have to assess the ways in which you may need to change your practice’s workflow in order to coincide with these transformations. Don’t procrastinate; act quickly to shift focus to the new healthcare structure. Here are some starting points:
Don’t throw Meaningful Use and PQRS out the window. In January 2016, more than 200,000 eligible professionals saw a decrease in Medicare payments because they failed to meet 2014 MU standards. However, now is not the time to breathe a sigh of relief; the components of these programs aren’t going away with the implementation of MACRA. To help you succeed, review your quality measures and identify high-performing areas – MACRA will use certain aspects of the PQRS and VBPM programs.
Take advantage of the resources of your medical societies and EHR vendor provides for you. Learn the basics and make sure you and the rest of your staff are educated about the new regulation, and how to improve the care you provide and demonstrate your value to payers. Make sure your vendor provides intuitive strategies to ensure actionable data collection and submission.
Know the timeline and when to prepare and implement the required changes. Keep abreast of CMS news so that you can stay updated on the latest news on MACRA developments and resources.
Outline your strategy well in advance and brainstorm with your staff. Review quality measure benchmarks and understand what is required for above-average performance, and implement practice strategies and workflows to meet quality and cost measures. The reporting period for Clinical Practice Improvement Activities is 90 days, so think through which time period in 2017 would work best for your practice’s selected CPIAs.
Review your CMS Quality Resource and Use Report (QRUR) for 2014 and the first half of 2015 to help you assess how you are currently being rated on cost and quality. You can find more information on accessing your QRUR here. Identify opportunities to improve the quality and cost of the care you provide and internal workflow changes that can be made to support care delivery plans. Think about who your potential partners may be; other specialists to whom you refer patients, in efforts to advance a coordinated care plan.
Make sure your EHR provides you with flexible tools to understand your quality metrics. You should be able to get data easily from your software and your dashboard should be customizable, granular, scalable and transparent.
Invest in a “MACRA-ready” EHR. Speak with your vendor or a potential vendor about how their software will be able to support your success through the transition to the new payment model. Does your vendor offer a patient portal? Does it enable secure messaging or appointment reminders? Is it certified EHR technology? Will your vendor offer you a MACRA-specific dashboard so that you will be aware, at all times, of how you’re performing in each performance category?
Remember that MACRA is a competition. There will be winners and losers – and your software will play an important role in your success. On which side of the bell curve will you be in 2017?