Preparing for MACRA to yield greater reimbursement — 4 takeaways

Written by Mary Rechtoris | October 20, 2016 | Print  |

CMS' final Medicare Access and CHIP Reauthorization Act rule will launch its new value-based reimbursement model under the Quality Payment Program on Jan. 1, 2017.  Dorrie Guest, managing director and physician enterprise and ambulatory services leader at Deloitte Consulting, told RevCycle Intelligence, now is a vital time for physicians to prepare to obtain maximum reimbursement.

Here are four takeaways:

1. Education is crucial as a Deloitte Center for Health Solutions found 50 percent of non-pediatric physicians have never heard of MACRA. Becoming well-versed in MACRA and how it could impact them financially, clinically and operationally will help physicians succeed financially under the rule.

 

2. To achieve profitability under MACRA, Ms. Guest suggests physicians align their care delivery and operation strategies with the rule's objectives. Some of these objectives include enhancing care coordination, transitions of care, chronic disease management, quality and outcomes, while also reducing costs and duplicate services.

 

3. Providers that failed to invest in population health management, clinical practice improvement activities and reporting capabilities may find it challenging to profit under MACRA. Ms. Guest says with MACRA, providers may need to continue investing in infrastructure and practice transformation projects.

 

4. As the healthcare industry continues to consolidate, many small practices may struggle to comply with MACRA's requirements. However, Ms. Guest noted successful small practices have been preparing for MACRA and have worked with commercial payers on shared savings and other risk arrangements.

 

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