Posted By Hope Alfaro On January 19, 2017

Do the MACRA – Changes are coming sooner than you think


To end the year on a high note, Centers for Medicare & Medicaid Services (CMS) released the Final Rule on October 14, 2016, for the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA). The changes provide the most complex and significant change to reimbursement in over 20 years. But how soon will these changes affect you?


Probably sooner than you think. The timeline is aggressive and performance measures will go into effect this year. It is already important to be tracking services and patient information in an easily reportable format. As healthcare providers, you will still be expected to provide the best care to your patients and you will be rewarded for doing so. You have choices, but ultimately the changes can help increase your payout and ability to provide care for patients, if you know the intricacies of the plan.


Education will be key for your team, so make sure your leaders (especially your C-suite) understand how the changes will affect your health center. Optimize what knowledge you have from Meaningful Use to help estimate your Merit-Based Incentive Payment System (MIPS) score.


One of the easiest ways to get ready for the upcoming changes is to make sure your EHR partner is up to the task. Your EHR should be certified and capable of adapting to payment changes quickly and efficiently. An effective EHR must be able to provide important reports easily. You should also expect more service from your vendor to help explain changes and decide the best path for your clinic, community health center or local health department. A true EHR partner will provide dedicated billing experts to guide you through the new details in the Final Rule. Your billing team is sure to have questions, as with any major change to reimbursements, and they should know where to go to get help.


Don’t lose out on reimbursements with an old system or a system that expects you to figure out complicated government changes by yourself.


For more details on billing to Medicaid and Medicare, visit the CMS website.


For more information about the new payment models, check out the new Quality Payment Program Website.

About Hope Alfaro

Hope Alfaro (Ahl-FAH-roh) is originally from Orlando, Florida but grew up in rural NC, She is addicted to knowledge and research and integrates these passions as a Marketing Executive for Patagonia Health. She created engaging content and news and keeps up to date with the latest health news to share with readers.