Moving forward with the implementation of MACRA and MIPS

The implementation process for the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-based Incentive Payment System (MIPS) is currently taking place, marking a shift from systems. While some are calling for a delay it is crucial not to underestimate the benefits and improvements that this new program can bring.

One area of concern is how small practices will be affected, as they make up 45% of healthcare providers in the United States. These practices already face challenges, such as access to Electronic Medical Records (EMRs) and affordable data reporting services. If not modified the proposed rule could worsen these challenges.

To address this issue three adjustments can make a difference;

1. Focusing on Reporting Requirements: The transition from reporting for Medicare patients to all-payer reporting, places a burden on small practices. It would be more manageable if they were only required to report for Medicare patients.

2. Moderating Reporting Rates: The proposed increase in reporting rates to 90% across all submission mechanisms is excessively demanding. A reasonable requirement of 50% would alleviate the strain on practices.

3. Preserving Measures Groups: The elimination of measures groups reporting mechanism poses a threat to the practice’s ability to report effectively. By retaining and improving this mechanism it would become more feasible for these practices to fulfill their reporting requirements.

MACRA’s Potential, For Positive Impact

With some concerns, MACRA offers a chance to streamline and enhance existing healthcare programs. The transition to the Quality Payment Program, which includes MIPS and Alternate Payment Mechanisms brings the promise of eliminating elements from programs.

In its year MACRA introduces a risky financial scenario by reducing revenue at risk to 4%. Subsequent adjustments allow for a progression up to a maximum of 9% promoting changes in a balanced manner.

As we embrace MACRA it is important to acknowledge the limitations of programs such as the Physician Quality Reporting System (PQRS) Value Modifier Program, Quality Tiering, and the EHR Incentive Program. These programs have played their roles. We are now making way for an integrated and efficient model.

The proposed rule addresses issues

Enhancement in Quality Tiering: Shifting from a pass system to a 100-point continuum in Quality Tiering allows for more nuanced evaluations and better differentiation between performance levels.

Advancing Care Information: The replacement of the EHR Incentive Program, with the “Advancing Care Information” performance category, emphasizes the importance of data exchange. This aligns with the state of healthcare focusing on the importance of sharing health data.

MACRA and MIPS provide a pathway towards an efficient healthcare system. While adjustments are necessary to protect practices the overall framework forms a foundation for positive change. As we say goodbye to outdated programs it becomes clear that we must adapt and embrace these changes without delay. Postponing the implementation of MACRA and MIPS may only prolong the inefficiencies that this new program aims to address.

Introducing Capline: Your Key to MACRA and MIPS Success

In the evolution of healthcare, Capline emerges as your ally ushering in an era of implementing MACRA and MIPS without subheadings.

Capline offers a solution that propels your clients to the forefront of MIPS readiness. Our state-of-the-art technology ensures compliance, setting the stage for your success. If healthcare providers do not report their data to Medicare they receive a negative payment adjustment of 4%.

However,, With Capline’s aid, healthcare providers will be able to submit the required data for the whole year to Medicare and can earn positive payment adjustments based on performance metrics that gradually go up to +9%. 

Capline equips you with a suite of tools including credentialing services and performance tracking through our Physician Quality Reporting System (PQRS) software module.

By offering EHR Manager and credentialing services your company establishes itself as an authority, in the field surpassing the capabilities of billing companies.

Capline’s dedication extends beyond compliance—it focuses on maximizing reimbursement and profitability for each client. Our services align with the criteria that determine providers’ scores ensuring an adjustment percentage.

In an industry where adaptability is crucial, Capline stands as your partner guiding you through the complex realms of MACRA and MIPS. Embrace this opportunity not to meet requirements but to thrive in the new era of value-based reimbursement with Capline’s unparalleled expertise and innovative solutions. Your success story, in the changing healthcare landscape begins with Capline.

 


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