Hayes' Healthcare Blog

Know the Score: Understanding the MACRA Advancing Care Information Category

Posted by Strategic Planning Team on June 14, 2017 at 9:00 AM

We are now six months into the implementation of MACRA and organizations have moved from the theoretical to reality when it comes to the law’s new requirements. The transition has put the CMS EHR incentive program – better known as Meaningful Use (MU) – in the rear-view mirror, replaced by the Advancing Care Information (ACI) component of the MIPS track of MACRA.

MU mandated that organizations meet minimum thresholds when it came to the use of EHR technology. ACI aims to take the integration of electronic records to the next level by focusing on performance, not just use. ACI expands MU to include MIPS eligible clinicians who were not previously eligible for incentive payments such as physician assistants, nurse practioners, clinical nurse specialists, certified registered nurse anesthetists and hospital-based EP’s.

CMS has outlined several major goals in designing the requirements for ACI:

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Topics: meaningful use, strategic planning, MACRA

3 Things That Most Likely Won’t Be Changing in Healthcare Under the New Administration

Posted by Don Michaels, Ph.D. on January 4, 2017 at 9:00 AM

The election and impending inauguration of Donald Trump combined with continued Republican control of both houses of Congress have sent waves of concern across the healthcare landscape. Predictions are running rampant on what the new administration will do, backed by a Congress itching to make changes – and cuts to existing programs.

The Affordable Care Act (ACA) – aka Obamacare – is clearly in the cross hairs, the target for significant change if not full repeal. There has been talk that the new administration will also address health insurance sales across state lines, health savings accounts, Medicaid payment methods to states and Medicare reform.

Although no one knows for sure what the eventual outcomes will be, there is little doubt changes are coming when it comes to healthcare in the next few years. However, not everything will be changing. Among the sea of uncertainty, there are islands of stability – certain things you can be fairly confident won’t be changing regardless of whatever else may be in store. Here are three foundational concepts we believe will remain as fixtures in the future healthcare environment.

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Topics: Change management, value-based care, MACRA

The MACRA Final Rule: Easing the Pain of Implementation

Posted by Don Michaels, Ph.D. on December 7, 2016 at 9:00 AM

When CMS released the Notice of Proposed Rule (NPRM) for the implementation of the Medicare Access and CHIP Reauthorization Act  - better known as MACRA – in April of this year, howls of protest could be heard throughout the healthcare landscape.  

Critics labeled the proposed rule “too complex, too onerous on small and solo practices, lacking in opportunities for many to participate in alternative payment models, and should be delayed for a full year at least.”[1] Some physicians claimed the rule was an attempt to drive them out of private practice and predictions of mass retirements were rampant.

In the six months after the release of the rule, nearly 4,000 public comments poured into CMS. The agency also collected feedback from over 100,000 physicians at outreach sessions held across the country.

The agency was paying attention. The final rule was released in mid-October and not only offers a series of clarifications, but also significantly softens some of the more aggressive components presented in the original proposed rule.

CMS addressed one of the biggest complaints – that there wasn’t enough time to absorb and comply with the new requirements – by essentially making 2017 a transition year. This gives organizations additional time to figure out what they need to do to implement the mandates of the massive new law.

Here are seven of the key outcomes, changes and clarifications resulting from the release of the final rule.

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Topics: value-based care, MACRA

The Two Sides of MACRA: Examining the Pros and Cons

Posted by Don Michaels, Ph.D. on August 10, 2016 at 9:00 AM

The shock and awe of the April release of the 962-page Notice of Proposed Rulemaking (NPRM) for the Medicare Access and CHIP Reauthorization Act (MACRA) has started to wear off as the healthcare industry continues to dig into the details. Slogging through the NPRM is an intimidating but necessary chore as healthcare organizations try to determine how it affects them.

MACRA represents change – significant change – in the way Medicare providers conduct business so it’s not surprising that much of the feedback has been negative. People dislike and fear change regardless of the reasons for it or the potential positive outcomes. Adding to the resistance is the fact that in recent years, changes in the healthcare industry have been aimed at providers like water from a fire hose and “change fatigue” is starting to set in. Lastly, providers know that most governmental changes to reimbursement have meant fewer collections for their practice. At best, they have been trained to hope that these types of changes are revenue neutral.

Despite the negative reviews, MACRA and the NPRM that puts it into action is not all bad. In fact there are several positives to be taken from the new law. Here is a look at the major pros and cons of MACRA.

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Topics: cms, Fee-for-service, value-based care, MACRA

MACRA 101: 9 Things You Need To Know

Posted by Don Michaels, Ph.D. on June 29, 2016 at 9:00 AM

Congressional passage of the Medicare Access and CHIP Reauthorization Act (MACRA) last year was only the beginning of a major upheaval in Medicare reimbursements. This past April the other shoe fell – all 962 pages of it. The Centers for Medicare & Medicaid Services (CMS) released the Notice of Proposed Rulemaking (NPRM) providing the details on the plan to transition healthcare providers from a payment system based on volume to one that rewards value. MACRA is the next step in driving healthcare organizations from a fee-for-service to a value-based care reimbursement model.

The massive NPRM document will be dissected and discussed (and maybe even read) for many months to come, but the implications for clinicians providing care under Medicare Part B are real and far-reaching. The major consequence for those of you who are Medicare providers is that you will soon have to choose to operate under a merit-based incentive program or transition to an Alternative Payment Model. Other than leaving the practice of medicine, there is no third choice.

Here are nine things you need to know to help you begin digesting this next significant change in the healthcare industry.

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Topics: cms, meaningful use, value-based care, MACRA

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