MACRA:
WHAT SHOULD I DO? BY EWA M. MATUSZEWSKI
This year I’ve been invited to various MACRA workshops sponsored by EHR vendors, quality improvement software specialists, independent consultants not to mention professional societies and the mother ship, CMS. The titles alone were overwhelming. I’ve sat in on the “Nuts and Bolts of MACRA” not to mention “Putting Together the MACRA Alphabet Soup” or “MACRA, MIPS and APM in a Nutshell.” So, who exactly is the authority on MACRA? What is your level of comfort in being able to discuss the MACRA Quality Payment Program to someone who may be interested in learning about the program?
A little bit of background may be helpful. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repealed the Medicare Sustainable Growth Rate (SGR) methodology for updates to the Physician Fee Schedule (PFS) and replaced it with a new approach to payment called the Quality Payment Program. The program rewards the delivery of highquality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. MACRA marks a milestone in efforts to improve and reform the health care system. Building off the coverage expansions and improvements to access under the Patient Protection and Affordable Care Act (Affordable Care Act), the MACRA puts an increased focus on the quality and value of care delivered. THE QUALITY PAYMENT PROGRAM AIMS TO DO THE FOLLOWING:
(1) support care improvement by focusing on better outcomes for patients, decreased provider burden, and preservation of independent clinical practice. (2) promote adoption of Alternative Payment Models that align incentives across healthcare stakeholders. (3) advance existing efforts of Delivery System Reform, including ensuring a smooth transition to a new system that promotes high-quality, efficient care through unification of CMS legacy programs such as Meaningful Use and PQRS. 14
TRIAD 2017 | ISSUE 1
In 2016, the MOA partnered with Practice Transformation Institute (PTI) to present a series of short webinars and inperson workshops on MACRA. Perhaps it was too soon to talk about MIPS and APM. Maybe the information was too overwhelming. It’s 2017 and time for you and your practice team to learn MACRA basics. You’ve heard the saying “the train has left the station.” Don’t run after the caboose when you have the opportunity of being the locomotive. You can begin slowly and progressively increase your knowledge of MACRA by attending a series of learning events. The first online interactive learning event takes place on April 17 at 6pm. So, who exactly is the authority on MACRA? It should be you! You should know the basics and after a bit of learning, provide snippets of accurate information. What is your level of comfort in being able to discuss the MACRA Quality Payment Program to someone who may be interested in learning about the program? After attending a few PTI webinars or in person workshops you should have a clearer understanding of MIPS, APM, and how incentives will align with high quality, efficient care. EWA M. MATUSZEWSKI IS THE CEO AND A CO-FOUNDER OF MEDNETONE HEALTH SOLUTIONS AND A CHAMPION OF INNOVATIVE PRIMARY CARE AND CHRONIC CARE INITIATIVES. SHE CAN BE REACHED AT: EMATUSZEWSKI@MEDNETONE.NET