Turning Down the Volume: Emphasizing Quality Care Under MACRA

The Medicare Access and CHIP Reauthorization Act (MACRA) comes into full swing in 2017. With only a few months left in the year, providers need to make sure they have a solid strategy in place for meeting MACRA specifications. Before developing a strategy, however, it’s important that doctors understand – what is MACRA?

Putting MACRA in Simple Terms

MACRA regulations replace the Sustainable Growth Rate (SGR) plan, which was put in place to limit Medicare spending and generally motivated providers to either increase or decrease the number of patients in their care to maintain a target fee schedule. Basically, SGR was:

  1. Bad for doctors because they needed to pay closer attention to patient volume rather than care administered.
  2. Bad for patients because they were just another number on a spreadsheet and received less focused attention when volumes were supposed to be high.

In 2011, a Meaningful Use (MU) program (part of the American Recovery and Reinvestment Act of 2009) was established to motivate providers to keep track of their patient care history via electronic health records (EHR), with the goal of addressing the shortcomings of SGR and administering higher quality care to patients. MU gave doctors and hospitals EHR reporting guidelines, which, when demonstrably followed, would reward practitioners with incentive payments for either Medicare or Medicaid (for providers; most hospitals can follow both programs).

While SGR and MU were at odds with one another, MACRA emphasizes quality care as a baseline. MU has been updated and baked into MACRA with two different incentive programs that providers can choose from: the Merit-Based Incentive Payment System (MIPS) or an Alternative Payment Model (APM). MIPS is the default payment program and analyzes the quality of care on four measures, Quality, Cost reporting, Recording care i.e. EHR usage, and Clinical practice improvements. APMs also measure providers on the quality of care and rely heavily on EHR reporting to do so.

If you’re following so far, you’re doing well. The bottom line here is that providers following MACRA guidelines will receive incentive funds by administering more dedicated, focused care to their patients as opposed to chasing volume goals. Oh, and the patients end up happier and healthier as a by-product. It’s a win-win scenario.

EHR: MACRA’s Achilles’ Heel?

There’s just one thing that providers need to be wary of: if they aren’t clearly reporting details and maintaining patient information, they’ll be unable to comply with MACRA. In short, they need to learn to love their EHR. With over half of providers stating they’re still not quite satisfied with their EHR system, however, that may seem like a real challenge.

Conventional EHR software is cumbersome and interrupts exam time (and the ability to administer quality care) by taking doctors’ focus away from the patient. Mobile EHR apps, however, have begun to address these issues. Intuitive interfaces that incorporate the ease of touch technology make the systems easily navigable. The integration of predictive clinical terminology systems makes ICD code selection fast and accurate. Voice recognition tools allow for a more natural examination process, and providers still have access to e-prescribing technology as if they were using their EHR system directly. Finally, these mobile EHR apps are fast and easy to implement and require no massive software changeovers.

Whether you’re still developing a MACRA strategy or you want to strengthen your current one, you can do it with iScribe, the beautiful, usable, and easy-to-implement mobile EHR app from iScribeHealth. To see iScribe in action, try it now.


References: https://www.healthcatalyst.com/7-Best-Ways-to-Prepare-for-MACRA-Today

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