MACRA / Regulatory Measures

Preparing for MACRA: A Comprehensive FAQ for Physicians (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.

This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.

It’s a practical guide complete with next steps for strategic and tactical planning.

The Who, What, and How of Health Outcome Measures (Executive Report)

Even though thousands of health outcome measures have the potential to impact the work we do every day, how well do we really understand them? In this article, we take a close look at the definitions, origins, and characteristics of health outcome measures. We break down the financial relevance of certain measures, the relationship between outcome measures and ACOs, and which measures impede, rather than enhance, a typical healthcare system. We review the role of an enterprise data warehouse and analytics, and we touch on the future of health outcome measures, all in an effort to provide deeper insight into some of the mechanics behind outcomes improvement.

The 7 Best Ways to Prepare for MACRA Today (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law in 2015, with major impacts starting in 2019. MACRA attempts to prioritize quality over quantity by letting providers choose between two value-based payment tracks: MIPs and APMs. Providers won’t have to choose until 2019; until then, they will receive a .5 percent annual increase.

The industry is conflicted about MACRA. On the one hand, many believe it is part of the overall shift to value-based healthcare. On the other hand, many say the administrative burden will overwhelm providers. Another area of MACRA controversy has to do with meaningful use which, contrary to what the CMS Acting Administrator said in 2016, isn’t going away with the introduction of MACRA.

Although it seems a ways away, MACRA’s base year will likely be 2017. Armed with the seven best ways to start preparing for MACRA today, and an EDW that provides clinicians with the self-service tools to monitor their performance, health systems can be ready to tackle MACRA when it finally goes into effect.