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3 steps to get ready for MACRA


Many practices are not sure how best to approach and prepare for compliance with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) payment reforms. Here are some short-term changes practices can implement to prepare.

Many practices are not sure how best to approach and prepare for compliance with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) payment reforms. Here are some short-term changes practices can implement to prepare.

Start small with a focus on quality

Due to the size and scope of MACRA, it’s wise for practices to start small with a targeted strategy when approaching compliance. Since quality accounts for 50% of the total Merit-based Incentive Payment System (MIPS) score in the first year-and most commercial payers are also moving towards linking fee-for-service payments to quality measures-this is a good area on which to focus initially. 


Related: MACRA doesn't spell end of independent medical practices


To comply with the regulation’s quality requirements, providers will need to report six measures from a list of nearly 300. Scores will be linked to performance on these measures (in the style of the Value-based Modifier), rather than the simple reporting of measures (as in the Physician Quality Reporting System).

Next: Assessing the technology


Physician practices should be deliberate when choosing which metrics to report, and engage in a thoughtful, data-driven selection process. Obviously, they should make sure to pick measures in areas where they already perform well, given that these outcomes will have a direct impact on practice income. 


ICYMI: MACRA author calls for delay in reporting requirements


To start, practices may want to assess all the measures for which they currently collect data and see which rise to the surface in terms of performance. 


Further reading: Top 9 MACRA threats that could become reality for doctors, patients


Practice leaders should also consult with all stakeholders to determine whether potential choices are aligned with the strategic direction of the organization. Problems will arise if there is a disconnect between which metrics physicians believe demonstrate quality and which practice managers or IT directors do. As such, practices should garner multi-stakeholder support across the practice, confirming that everyone feels the measures are fair, sensible and represent the best of the organization’s performance. 

Assess the technology

In addition to strategically selecting metrics, practices should take a hard look at the technology they have in place to make sure it will support MACRA compliance for both the immediate and the long-term future. Technology is key to successfully navigating the nuances of MACRA because it allows practices to measure and report cost and quality metrics. Note that not all systems will be able to report on all 300 quality measures right away. Consequently, practices should confirm that whatever technology they have in place can accurately report selected measures. 

Next: Developing a long-term plan


Develop a long-term plan

After ramping up short-term compliance efforts, practices should work on creating an overarching strategy to comply with MACRA. This will involve looking at how the organization plans to demonstrate performance with quality in the future, as well as addressing resource use, advancing care information and clinical practice improvement activities. 

Blog: MACRA/MIPS is the problem, individual health freedom is the answer

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