Five things you can do today to prepare for MACRA


Are you unsure of where to begin when it comes to preparing your organization for success under MACRA’s* new quality payment program (QPP)? Although there is uncertainty swirling around about its fate, there is no way you can pretend you will be okay if you sit back and watch and wait. The time to start is today – really yesterday, to be quite frank.

Even though the financial impact from MACRA won’t be felt until 2019, initial pay-outs and penalties will be based on 2017 data. At a minimum, MACRA requires at least three months of 2017 performance reporting on most metrics and those who do nothing will face a four percent penalty for nonparticipation. To put this into perspective, if your organization bills Medicare $40,000,000 and you are penalized -4%, a -$1,600,000 adjustment could be in your future.

MACRA’s QPP is not a one-and-done, check-it-off-your-list type payment program. To find success under MACRA, think of it like you would if you were preparing for a marathon. You need to train your organization for what’s ahead, by being mindful of your current state as well as how will adapt and progress along the way. MACRA is certainly not a sprint, it will take a long concerted effort to stay at the head of the pack.

Here are five ways to prepare for MACRA:

1. Get educated

Understanding what MACRA is and how it works is the first step to successfully navigate the new program. See our recent blog on the nuances of MACRA, and be sure to watch the MACRA webinar replay with Becker's Hospital Review.

2. Review historical data

Take a close look at how you did under the Physician Quality Reporting System (PQRS) and Meaningful Use (MU), which MACRA builds on. Both reporting programs are good indicators on where you’ll stand with MACRA – and what you need to do to improve.

3. Choose your pathway

Once you have fully familiarized yourself with MACRA, you have a decision to make. Does your practice best fit into the Merit-Based Incentive Payment System (MIPS), which is where most clinicians will fall; or, do you qualify for participation as an Advanced Payment Models (APMs), which allows physician practices more earning potential for taking on some risk related to their patients' outcomes.

4. Assess your technology

Do you have the technology in place to monitor physician performance and report the required quality measures to CMS? To do so, you’ll need to integrate your universe of data into one dataset in order to effectively analyze and report performance for your practice. You’ll also need real-time visibility to flag issues and make improvements along the way. Remember, the goal is continuous improvement towards value across the continuum of care.

5. Create a go-forward plan

Do you have a good handle on all of the support resources you will need to meet MACRA requirements? What does your team look like? Have you defined your timeline for success? How will you keep abreast of changing regulations and keep key resources informed? If you haven’t done so already, you’ll need a plan that identifies who and what needs to be in place to successfully meet the MACRA reporting requirements.

With the launch of MACRA on January 1, 2017, the race to prepare for success has begun. nThrive empowers health care organizations with the knowledge and tools necessary to prosper under the MACRA regulations. From our practice improvement and program transformation advisory services to MACRA education and MIPS performance assessment and reporting services, we will run beside you as you align, mobilize and motivate your organization on its path to value-based care transformation. For more information, contact us at solutions@nThrive.com.

*The Medicare Access and CHIP Reauthorization Act of 2015