MACRA Implementation: Have you Established a Plan to Succeed?

By now, most organizations participating in The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the groundbreaking CMS payment model, have reported their first year of data. They are awaiting their results to see how Medicare provider payments will be adjusted once MACRA fully kicks in, as of January 2018.The most foresighted organizations, however, are putting in place plans to prepare systematically to succeed under one of MACRA’s quality payment programs (QPPs), i.e., the merit incentive payment system (MIPS) or an advanced alternative payment model (APM). Without such a MACRA implementation plan, providers will find themselves coming up short regarding their performance in 2018, where all four performance categories under MIPS will be measured (Quality, Cost, Improvement Activities, and Advancing Care Information (ACI)) and more risk is added into the system, with providers facing payment increases or decreases of 5%.So, what is your plan to succeed with MACRA?

Have you:

  1. Used your performance in the quality and cost programs that preceded MACRA (PQRS and VPM) to create a roadmap for success under MIPS or an APM?
  2. Selected quality metrics that can most assuredly be moved into the high-performance level under MACRA? Remember, in MACRA past performance can be an indicator of future success.
  3. Selected improvement activities that can best help to move quality, cost, or ACI measures into the high-performance range?
  4. Begun initiatives that focus on lowering costs to Medicare, which you are now at risk for reducing?
  5. Mapped out a plan to make sure your EMR system is capable of performing all the tasks required to achieve maximum credit under the ACI section of MACRA?

Most importantly, are the key players, i.e., the Medicare providers in your organization, on board with the above program and effectively engaged to implement the plan before data reporting is due for 2018? It is not too late to implement a strategy to succeed under MACRA, but the clock is ticking.Unlike technology vendors who merely help you with data tracking and reporting, Coker Group is a full-service advisory firm. Our experts can help custom craft a blueprint for success with MACRA implementation. Whether it’s assisting with metric selection, developing and implementing clinical practice improvement activities (CPIAs) that move the dial on performance measures, helping in developing an APM that is appropriate for your organization, or with assessing and improving the functionality of your EMR, Coker can help.

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