Optimize EHR for MACRA - What Does it Mean?

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) marks an entirely new era in physician reimbursement—one characterized by quality, cost containment, and population health management. MACRA essentially shifts Medicare payments from fee-for-service to pay-for-performance that rewards participation in risk-bearing payment models.

To participate in MACRA, physicians must choose one of the following two tracks:

1. Advanced Alternative Payment Models (APM)
2. Merit-Based Incentive Payment System (MIPS)

The choice that physicians make today will affect their payment beginning in 2019. Physicians participating in MIPS will see a sliding-scale bonus or penalty ranging from 4% in 2019 to 9% in 2022. The bonus or penalty derived from 2017 data is based on a composite score that includes these components: Quality measures (60%), advancing care information (25%), and clinical improvement activities (15%). Physicians participating in APMs will see a bonus of 5% of Part B professional services payments between 2019 and 2024.

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What is EHR Interoperability?

The Office of the National Coordinator for Health IT’s Nationwide Interoperability Roadmap includes many detailed and lofty goals that could benefit even the smallest of group practices. But small group practice leaders need to understand the ins-out-outs of the interoperability plan before putting the pedal to the metal.

The Office of the National Coordinator for Health IT (ONC) spent much of 2014 and 2015 drafting, hearing comments and revising its Nationwide Interoperability Roadmap. The end result: A 10-year, 166-page plan that starts to shirt the focus of the federal government away from its long-term Meaningful Use program that was designed to incentivize provider organizations to use IT, and more toward the interoperability of those technologies.

It’s definitely some heavy reading for small group practice leaders. But you’re in luck. Here in this blog, we’re offering a crib sheet, of sorts, to this substantial tome – and are providing some straightforward answers to your most likely questions to help you get on the path toward interoperability:

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