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How MACRA can Effect the Healthcare Industry

 Healthcare Billing Services

What is MACRA

MACRA has been in the limelight these days, but very few of the physicians, hospitals or healthcare sectors are well aware about this act.

The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) is a law which has been designed to improve Medicare by helping clinicians emphasis on care quality in order to make patients healthier. It can boost or even cut physician reimbursement depending on their quality performance and other measure.

The law also includes new funding slants for technical assistance to providers, funding for measure development and testing, enabling new programs and requirements for data sharing, and establishing a new federal advisory group.

How does MACRA work

MACRA will revoke the Sustainable Growth Rate (SGR) Formula that has helped in determining the Medicare reimbursement rates for physicians and will swops it with new methods of payment. MACRA’s value based programs will depend on two re-imbursements structures:

Merit Based Incentive Payment System (MIPS ): This system combines parts of these incentives programs into one:
  • Physicians Quality Reporting System (PQRS)
  • Value Modifier (VM)
  • Medicare Electronic Health Record (EHR )
All the eligible professionals will be paid based on their quality, resource, eloquent use of certified EHR technology and their improvement in clinical practise.

Advanced Alternative Payment Models: In this system the most advanced alternative payment models will be considered eligible. They can qualify for even higher level of re-imbursements, which will be performance based.

Benefits of MACRA

MACRA will provide a platform to select and practise clearer, more manageable, more eloquent measures that will improve the reporting accuracy and effectiveness. It will bring a change for all the patients and will encourage a broad-based transparency and accountability. This change will occur because to effectively manage patient care, providers will be dependent on good and accurate data which will mostly be from multiple delivery systems. This automatically means that the technology and data infrastructure will require a modification. The healthcare scenario is transforming. To go with the flow, the practice methods also need to be changed .This knack to shift the focus on the new structure, required by value-based reimbursement is critical. Nationwide Healthcare Billing Services can guide you in this transformation. NWHBS is a premier provider of healthcare revenue cycle management services providing quality services along with increased cost reduction.
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