L. Patrick James, M.D. is Chief Clinical Officer for Health Plans & Policy, Medical Affairs at Quest Diagnostics, the world’s leading provider of diagnostic information services. With Inovalon, the company also provides Data Diagnostics, a point of care a
There are cogent reasons for healthcare professionals to amp up their participation in Medicare Access and CHIP Reauthorization Act (MACRA) as soon as possible
Given the challenges with Medicare payment reform, it may be tempting for physicians to implement MACRA slowly at first and learn along the way. Indeed, CMS has designed the rollout to enable those affected to “pick their own pace.” Adding to the temptation to opt for minimal participation in 2017, full payment adjustments won’t go into effect until 2019.
There are, however, cogent reasons for healthcare professionals to amp up their participation in Medicare Access and CHIP Reauthorization Act (MACRA) as soon as possible in 2017.
First, MACRA’s initial performance period for data collection began on January 1, 2017. Physicians who weren’t ready to start collecting data at the beginning of the year can choose to start any time up until October 2, 2017. This data will help CMS determine payment adjustments beginning in 2019.
Most physicians will likely adopt the MIPS payment track and, since Merit-based Incentive Payment System (MIPS) must be budget neutral, for some to earn performance bonuses others must be penalized. Ultimately, this means compensation will reflect how well physicians perform relative to others.
Considering that the bonus reporting process can be complex and onerous, it follows that physicians and practices taking a wait-and-see approach could face an uphill climb in 2019, while those who pick a faster pace may be better positioned financially.
Much depends on how well prepared a physician is to collect performance data. Beyond that, physicians will need to ensure that data related to quality and other performance metrics assigned under MACRA are available in a form physicians can use to align care. Here, technology can play a role.
Studies reinforce that manually navigating reporting requirements is an administrative burden, not to mention cost-inefficient. The time spent by physicians and staff to track quality measures translates to an average cost of $40,069 per year per physician, according to a study published in Health Affairs. Physicians and staff also use 12.5 hours per week “entering information into the medical record only for the purpose of reporting for quality measures from external entities,” the study says.
Technologies already exist to help physicians navigate this complexity so they can focus more on patient care.
Electronic health records (EHRs) are not a sole fix, but are increasingly complemented by other health information technologies designed to surmount EHRs’ limitations, such as lack of interoperability.
Technologies that provide real-time access to patient data and performance measures in the physician’s EHR and workflow, for instance, can go a long way toward maximizing financial opportunities for good performance while also improving quality care.
MACRA may be complex, but there are rewards for tackling that complexity early and decisively. With so much riding on performance in 2019, this year is not one to spend on the sidelines.