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MACRA Consulting Services

As healthcare providers got used to the requirements of PQRS and Meaningful Use, here comes MACRA! Very much like its predecessors, MACRA needs healthcare providers to be compliant as well as report the compliance by submitting regular reports to CMS.


MACRA came in effect from Jan 1st, 2017, to track and report physician performance based on performance in four categories:

  • Quality.
  • Resource use.
  • Clinical practice improvement activities.
  • Meaningful use of an electronic health record system.

MACRA is abbreviation for Medicare Access and CHIP Reauthorization Act of 2015.


MACRA REPORTING

MACRA MANDATE

This new mandate adds to the long list of other mandates that healthcare practices have to comply with. This law covers approximately 55 million clinicians (medical personnel eligible under MACRA) that include physicians, clinical nurse specialists, nurse practitioners, physician assistants, and nurse anesthetists.

Trying to figure out MACRA and its requirements can be extremely challenging task for practices and may consume time and efforts which otherwise can be focused on patient care which is at the core of their business.

To simplify an otherwise complex rule, MACRA is based on a points system. Doctors are compared to each other based on this points system. What someone makes in terms of revenue is determined based on the score they achieve comparing what they did vs what they were supposed to do.


Below infographic outlines all the details and important timelines related to MACRA.

MACRA INFOGRAPHIC

MACRA Accomplishes 4 Goals:

  • Replaces the SGR (Sustainable Growth Rate calculation that previously served as the basis for annual Medicare professional fee schedule increases) and sets predictable Medicare rates
  • Accelerates the shift to “Value-Based Payment” to reward quality over quantity of care.
  • Ends MU, PQRS, and the Value-Based Payment Modifier as separate Medicare programs with their own incentive/penalty structures.
  • Consolidates these programs into a new program, effective 2017, with financial impact beginning in 2019.

Unfortunately, choosing not to participate is not an option for the practices due to the disincentive hitting them in 2019.


MACRA Goals

Healthcare providers are facing increasing pressure in two areas:

  • Quality – Maintaining and demonstrating adherence to quality measures as prescribed by mandates
  • Cost – Staying profitable even with increased paperwork

ROI

Your Return on Investment (ROI)

You are eligible for a maximum incentive of 4% by fully adhering to the MACRA program (under MIPS stream in 2019). An additional increase of up to 10% can be attained if you are an exceptional performer.

Compute your ROI to see if the resources you employ are worth it.
We are here to help!!

You do not need to expend your resources on paperwork but rather have them focus on the core business which is patient care. Physician practices are able to see more patients and increase revenue as they leave the paperwork to the experts.


Comtron’s MACRA Consulting Services

With a proven track record of helping physician practices achieve and demonstrate compliance in major healthcare mandates like Meaningful Use, PQRS, HIPAA, and other compliance programs, our team is well equipped to handhold you and your practice staff through the MACRA compliance journey.


We Do:

  • Determine whether your practice qualify for MIPS or APMs, based on analysis of your Medicare patient volume and reimbursements. Being a part of an Accountable Care Organization (ACOs) or other coordinated care programs also plays a vital role in this determination.
  • Identify the number of eligible clinicians for enrollment in the program.
  • Conduct detailed training sessions for you and your staff, where basics of the program are covered. Our trainers are happy to answer any specific questions you or your staff might have.
  • Track your performance with regard to adherence to measures and provide regular and ad hoc reports and alerts.
  • Attest/submit compliance data to the registries for you.
  • We can be contacted via phone or email.

Frequently Asked Questions

Is there a guarantee on incentives?

No. We cannot guarantee incentives unless you are not meeting the compliance measures. We can provide regular reports and alerts to you, so that you can stay on track to achieving incentives. The practice needs to ensure that they are meeting the compliance measures.

Will you manage reporting and documentation?

Yes, we will. Our experts are adept in using various EHR and PMS systems for MU and PQRS and can run regular compliance reports. You may need to provide us with logins or remote connections to your existing systems.

How and when will you connect to our system?

We may connect to your system through a dedicated user account or through remote connections securely. Our staff can work afterhours so that your practice functioning is not affected. However, we may need assistance from your staff if we are trying to connect through remote connection.

What is the best way to reach for support?

We provide both email and phone support. We have dedicated lines which ensures the help is readily available.



Quality. Service. Teamwork.

Every member of our staff recognizes that the key to your satisfaction is working closely with you—making sure Comtron understands your unique requirements and going the extra mile to meet those expectations.