MACRA Insights for Clinics and ACOs

17 October, 2019

All ACOs should achieve 100% Quality for MIPS in 2020

The 2020 Proposed Rule gives ACOs a big advantage when reporting CQM for MIPS next year.  For those ACOs who can influence their clinics to report quality on their own (rather than have the ACO do it for them), the rules give a big bonus (extra...

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11 October, 2019

Practical Implicationson 2020 MIPS Proposed Rule

 This year, CMS published its shortest set of updates to MACRA yet.  Of course, "short" is a relative term and there are only 108 pages of Federal Register content to contemplate.  After a rather dramatic set of 2019 changes, we might be starting...

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23 September, 2019

With MIPS, CMS Isn’t Always Right

Doug Blinco is a colleague of mine, who works in Wellstar Health Systems, also part of a large ACO in Georgia.  Doug recently shared an experience with me that we are calling “CMS doesn’t always get it right”.  Over the course of the several...

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5 September, 2019

More Money in MACRA Means more Monitoring

There is a new Best Practice in town.  Really - it is worthwhile this year!  MACRA reimbursement goes up each time thresholds get higher, and scoring gets harder.  2019 will be the hardest year yet - and that difficulty should drive more dollars...

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24 June, 2019

Your MACRA Payments through 2025

I can't tell you how often I've heard that MACRA payments can't be predicted.  Hogwash!  The rules are complex, and contain variables adjusted annually.  But here is a nice table that can help with CMS-originated variables:

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13 June, 2019

Estimating MACRA reimbursement over 5 Years, as Program Changes Kick In

Prior Results are not an indicator of future performance!  Whether you decide to join an ACO, or to remain independent,  your decision contractually impacts your next five years of Medicare reimbursement. Financially analyzing "join or not join"...

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16 May, 2019

MACRA, Provider Contracts and Credentialling

The first two years have been easy.  CMS defined MACRA that way with transitional rules designed to attain high participation, while minimizing penalties for small and rural providers.  The practical upshot has been that penalty pools are...

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6 May, 2019

MACRA CQMs Need More Attention This Year

In the big picture, CMS is doing the "right thing" with Clinical Quality Measures.  The concept that providers can evaluate their Quality performance in near real time is a giant leap forward from the world of year-end reporting with Manual...

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30 April, 2019

Monthly MACRA staffing metrics

ACOs are not big organizations.  And everyone has a job to do, without a lot of time built in for unexpected work.  

We believe strongly in measuring and managing Monthly MACRA, throughout the year.  With regulatory changes in 2019,  Monthly...

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26 April, 2019

Personalize your ACO Provider newsletters for MACRA

If you want to engage ACO TINs in your Monthly MACRA program, you will want a simple, relevant and consistent communication vehicle.  

A well-organized  MACRA database should be the source for newsletter content customized to each TIN.  The first...

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