As of July 2016, studies showed that only 50 percent of nonpediatric physicians were aware of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. But with the onset of the new year, medical professionals can no longer afford to be in the dark.
Passed by Congress almost two years ago, MACRA has already been instrumental in eliminating the Sustainable Growth Rate (SGR) for Medicare Part B payments (Medicare, Medicaid, and TRICARE patients) while establishing a 0.5 percent annual increase through 2019. But it will soon bring about additional changes, including a new value-based compensation model that requires practices to report quality data as of Jan. 1, 2017. Here’s what you need to know:
Are you prepared to send quality data to CMS now?
The most notable change ushered in by MACRA may be the shift from fee-for-service payments to value-based compensation. To achieve this, the law is introducing two new physician incentive systems: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). The first MIPS performance period has already started (Jan. 1, 2017, to Dec. 31, 2017), which means quality data is due to CMS beginning in January 2017. Failing to follow this requirement could result in a Medicare payment adjustment in 2019.
Does it make sense for your practice to comply?
Some practices worry that MACRA could negatively impact their business, but in fact it may prove financially advantageous for practices that are adequately prepared. Nevertheless, some may wish to remain independent. If you’re unsure about what MACRA may mean for your practice, consider conducting a financial analysis. This can help you determine whether it’s beneficial for your practice to comply.
How will you respond to industry changes?
The changes heralded by MACRA will affect you regardless of your decision to comply with the new law. Many private insurers are following MACRA’s lead in the transition to value-based compensation, and it’s unlikely that this trend will reverse anytime soon. If you haven’t already, now is the time to evaluate new approaches to patient care, hire the appropriate staff, and implement the necessary processes.
What can you do today?
It would be a challenge to fully understand MACRA in one day—after all, it’s comprised of more than 2,500 pages of rules and guidelines. But there are steps you can take to prepare. For starters, DS+B’s healthcare advisory team
can help you get a clear picture of the financial impact MACRA could have on your practice, as well as the revenue generated by Medicare, Medicaid, and TRICARE patients. Evaluating the impact MACRA could have on your practice is critical in a changing industry—ignoring it will only put you behind.
 Deloitte Center for Health Solutions 2016 Survey of US Physicians