The full implementation of MACRA can be felt now. So much has happened after CMS released the 962 pages of proposal during 2015. Causing several confusions, anticipations, and anxieties, this complex law has certainly brought about a revolution in the medical industry – the final version with 2400 pages has been created by CMS after careful analysis of suggestions-making MACRA greatly flexible
Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – its Direct Impacts
A. Simple Quality Reporting
o In the domain of quality payment program, the Merit –Based Incentive Payment Systems have replaced the three earlier programs, namely, Physician Quality Reporting System (PQRS), Meaningful Use (MU), and Value-based Payment Modifier (VBM). Moreover, there are other flexibilities such as reduced needs of measures to report on.
B. Sustainable Growth Rate (SGR)
o Physicians will be able to avoid heavy cuts that used to occur under the SGR regime. Repealing SGR was for facilitating the transition to the value-based reimbursement model
C. Increased opportunities and reduced penalties
o Previously, physicians were slapped with overlapping penalties. In MACRA, Clinical Practice Improvement Activities, a list having more than 90 activities needs to be performed by eligible clinicians – physicians get credit for efforts made – this moves away from the ‘all-or-nothing’ model
D. Reduced Negative Adjustment
o An eligible clinician will be able to avoid negative adjustments in this system. Eligible clinicians are allowed to operate at their own pace as per the new rule.
E. Efficient use of Technology
o Physicians are needed to efficiently implement supportive technologies. They have to record quality data, inculcate preventive care, and fill the gaps in care, care coordination, disease management, and several other activities that rely on advanced technology. More efficient use of EHRs and other systems are necessary
F. Better Reimbursement
o Payment received by physicians will increase by 0.5 percent till the year 2019.
G. Exceptional Performance will be rewarded
o Achieving a new threshold score of 3 helps you avoid negative adjustments.
CMS has made the first year, namely, 2017, the ‘transition year’; during this period, MACRA in a highly flexible version will be in place.
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