Value-based care

MACRA and value-based reimbursement: Full steam ahead

By Chris Emper

Blog    MACRA and value-based reimbursement: Full steam ahead

With a new President and Administration now in power, many practices are looking for guidance on how these political changes will impact various healthcare reform initiatives and how providers can prepare for such changes. When it comes to MACRA (The Medicare Access & CHIP Reauthorization Act) compliance, the answer is to move forward – full steam ahead.

MACRA represents significant progress toward value-based reimbursement and sets a framework for shifting physician payments for Medicare away from fee-for-service. Unlike other aspects of healthcare reform, it was passed into law with strong bipartisan support—over 90 percent of lawmakers voted for it in 2015. As such, MACRA implementation will most likely move forward unchanged in 2017, and organizations need to be ready.

MACRA's initial performance period began January 1, 2017, but in 2017 providers can ease into compliance by choosing to report for either a partial year or with partial data, without fear of being penalized. However, note that full participation in the first year is virtually risk-free because CMS has made 2017 a transitional year. Consequently, providers can use the year to test their reporting capabilities, identify potential compliance shortfalls, and implement solutions to optimize their MACRA performance in 2018.

There are also potential payment incentives for organizations that report a full year with a complete set of data. And with Medicare FFS reimbursement rates holding flat in 2017, capturing payment incentives can help organizations keep pace with inflation, effectively offsetting the lack of FFS payment rate increases.

Another reason to move forward with MACRA participation in 2017 is that many providers are already doing the work. Those that have participated in Medicare's Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-based Payment Modifier (VBM) programs will be well positioned to succeed in MACRA's Merit-Based Incentive Payment System (MIPS) with the similarities between the programs.

Given all the uncertainty surrounding various healthcare reform efforts, it may be tempting to put certain initiatives on hold this year. However, by pressing ahead with MACRA compliance in 2017, organizations can take a risk-free step toward value-based care, while preparing for greater success in years to come.

To learn more about how NextGen Healthcare can help your organization comply with MACRA, visit nextgen.com/insights/understanding-macra.

Chris Emper

Government Affairs Advisor, NextGen Healthcare

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