Webinar recap: MACRA changes the rules for all health care providers

By nThrive | Posted: 08/21/2018

MACRA Webinar Recap

In today’s post-MACRA* environment, value-based performance has emerged as king, presenting a host of new challenges for all health care providers – large and small. During a recent health care webinar hosted by the Ohio Health Information Management Association (OHIMA, an affiliate of AHIMA), Moshe Starkman, nThrive senior director of Value-based Reimbursements, emphasized that payment models and expectations have irreversibly changed in favor of value but that “one size does not fit all.”

He explained that “while there are stark differences between rural populations with limited revenue sources and urban areas replete with resources and people in need of health care, the real challenge is exploring how value-based care works for your unique environment, ultimately defining your version of success.”

As context, Starkman provided his audience with a brief history on MACRA, as well as what it fundamentally changes. (See our recent blog, “Value-based reimbursements in rural health care markets,” for more details on how MACRA came to be and the impact of MACRA on hospitals.)

“History shows us how we got into today’s mess,” he explained, “with MACRA, or more accurately the Quality Payment Program (QPP), providing a meaningful path forward. More specifically, MACRA fundamentally changed the relationship between government as payor and clinicians caring for Medicare beneficiaries. In turn, private payors have begun to adopt these new models are quickly redefining the norm for health care reimbursements.”

Viewing MACRA through different lenses

All health care business leaders should be concerned with three major business issues related to MACRA:

  1. Revenue Cycle – fewer fee-for-volume payments in favor of managed costs and quality improvement through value-based care and value-oriented reimbursement models
  2. Technology – Mandates to increase secure information sharing and patient access through an emphasis on cloud-based technology and practice improvement
  3. Reimbursements – Represented by shared risk and alternative payment models (APMs)

In this webinar, Starkman highlighted how responsibility for VBR (value-based reimbursement) resides across multiple leaders and specifically addressed considerations facing the Chief Financial Officer (CFO), Chief Technology Officer (CTO) and Chief Information Officer (CIO).

“All are key stakeholders in MACRA’s success,” he explained. “If you are a CFO, value-based care will affect your revenues as more care shifts to lower-cost settings. You’ll need to take steps to rebalance or otherwise identify new revenue sources.”

For CTOs, he emphasized that it is important to reconsider Health Information Technology (HIT) as a solution to a service. “Technology leaders need to consider how to best engage patient populations while helping to define the vehicles for stronger provider-patient relationships.”

CIOs, for example, must consider how Internet of Things (IoT) has ushered in an era of unparalleled data collection and supplemental patient information. “How do we incorporate this new information?”

No going back

With unprecedented change putting so much at stake, Starkman emphasized the need for health care leadership teams to embrace the imminent shift to value-based care services as the new normal.

“There is no going back,” he told his audience. “I cannot emphasize enough the importance of investing in MACRA education at all levels of your clinically integrated network, hospital and group practices to facilitate organizational alignment and make VBR work to your advantage.”

Visit nThrive’s MACRA webinar page to access the On-Demand recording of “Value-based Care: Thriving in a Post-MACRA Payment Model.”Learn how our nThrive CMS-certified registry can help your care organization meet MACRA requirements in 2018 to achieve the highest results.

*Medicare Access and CHIP Reauthorization Act of 2015