Tips for MACRA Success

For healthcare organizations to succeed with the complicated Medicare Access and CHIP Reauthorization Act (MACRA), a lot of forethought and planning needs to take place. That could mean adding dedicated staff or hiring revenue cycle consultants, transitioning current staff to focus on MACRA, or expanding clinical documentation improvement (CDI) and strengthening coder skills.

While MACRA was signed into law in 2015, the Centers for Medicare and Medicaid Services has released updates to it and relaxed other portions of it. Staying on top of current changes and monitoring potential future updates requires more effort from providers. In an interview with RevCycle Intelligence, Rebecca Altman, managing director at Berkeley Research Group, emphasizes the need to have staff dedicated to MACRA compliance.

“We have put a lot of challenges on our providers, but that’s why I say the critical piece to this is not just having physician leadership and engagement, but having the human capital and the resources embedded in your practice to really assist these physicians in making the changes in the EHR, ensuring that the data is being collected and it is complete when you submit it, and ensuring when those performance periods are,” Altman, a former registered nurse, told the publication.

Altman had the following recommendations for providers:

  1. Regardless of practice size, physician practices should make sure at least one or two physicians should take on the role of MACRA experts, especially since physician engagement is crucial to success with MACRA. It might be necessary to change their duties and responsibilities to stay in this role, according to Altman.
  2. Practices could consider hiring a full-time staff member to stay abreast of MACRA changes and requirements. Altman recommends someone like a clinical informaticist or someone with a broad clinical base of knowledge as well as an understanding of data and quality reporting.
  3. While large practices may have the resources to add staff and transition physician roles, small, rural practices may be unable to afford this. In this case, Altman says they need to emphasize coding quality and CDI programs.
  4. Practices should also look into adjusting their electronic health record (EHR) workflows to prompt users to check and see if clinical quality measures have been met, such as checking immunizations
Mary Butler is the associate editor at The Journal of AHIMA.

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