With Congress attempting to repeal the Affordable Care Act (ACA), and with the president issuing executive actions to roll back portions of the ACA, some in the medical community have been wondering whether the Medicare Access and CHIP Reauthorization Act (MACRA) also faces an uncertain future.
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With the Centers for Medicare & Medicaid Services recently releasing rules for how MACRA will operate in 2018, medical practices, both primary care and speciality ones, must press on in preparing to address the law's requirements.
Such careful preparation is made easier by the use of scorecards that act as critical tools to help a practice track its progress toward key goals as defined by the legislation. Through the use of various scorecards, practices can increase the likelihood that they will fall among the financial winners that the law will create, and not among its losers.
Ira Nash, MD, the executive director of Northwell Health Physician Partners (NHPP), a New York area group comprising 2,800 clinicians, reports that his practice has actually been using scorecards for quite some time, initially without any connection to MACRA. However, the practice has adapted many of its scorecards to reflect MACRA’s definition of items to be measured and its requirements.
Catching a problem
Nash provided one example of how internal scorecards helped his practice improve in terms of the data it would submit to regulators. The administrators at NHPP observed that mammography rates among their patients seemed lower than the clinicians thought those rates actually were. “We found that part of the problem was that the women were getting mammograms outside the system and doctors weren’t correctly documenting in the record that they had received an outside mammography report.”
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As a result, management chose to relieve doctors of the task of making sure that outside mammography reports were entered correctly.
“The result, of course, was that the mammography rates went up,” says Nash. “It wasn’t that more women were getting mammograms. Our process was more consistent and less consumptive of physician time and attention.”