2016-04-20 13:00:17 UTC

10 Practical Steps to Prepare for MACRA

April 20, 2016

AGA offers tips and programs to help you prepare for and thrive in an accountable care environment.

Any day now, the government will release the proposed rule that implements the Medicare Access and CHIP Reauthorization Act (MACRA). While we don't yet know specifics, we do know that it shifts reimbursement to pay for quality and value. The good news for AGA members is that we have been preparing for years to support you through this shift to pay for value.

Take some time now, before the regulation is released, to become more familiar with the programs under MACRA and begin to prepare for the changes it will mean for your practice. Here are the top 10 things to do now to prepare for MACRA.

  1. Learn the basics. Visit the AGA Roadmap to the Future of GI Practice for practical, easy-to-use information to help improve the care you provide patients and demonstrate your value to payors.
  2. Be prepared. Use the AGA Federal Quality Improvement Programs Timeline to help you prepare and successfully implement the required changes for federal quality improvement programs.
  3. Ensure that your practice is up to speed with current initiatives. Many elements of the Merit-Based Incentive Programs (MIPS) will be derived from existing programs, so be sure to assess where you are currently at with Physician Quality Reporting System (PQRS) reporting, EHR Meaningful Use and the value-based modifier. The AGA Roadmap to the Future of GI Toolbox can help. 
  4. Review your practice’s Quality and Resource Use Reports (QRURs) for the 2014 calendar year and the first part of 2015. The QRUR will help you to understand how you are currently being rated on cost and quality. Get up to speed quickly on QRURs.
  5. Participate in 2016 PQRS by registering for the Digestive Health Recognition ProgramTM (DHRP) HCV or IBD qualified registries or the 2016 AGA Qualified Clinical Data Registry. If you or your organization did not successfully meet meaningful use for an electronic health record reporting period in 2015 and would like to apply for a hardship exception, the deadline is July 1, 2016.
  6. Be aware that a new program, the clinical practice improvement activities, will count toward your MIPS score in addition to PQRS, value-based modifier and meaningful use. CMS has yet to provide specifics, but these new activities will incentivize the implementation of new processes to expand access to physician practices, improve population health management, enhance care coordination, improve patient safety and engage Medicare beneficiaries. 
  7. Get your staff on board to brainstorm ways to improve patient communication and whether outside resources may need to be added to help patients stay healthy… and happy. Don’t forget that CMS Physician Compare will allow patients to compare providers in ways they hadn’t been able to before. 
  8. Strengthen your relationships with your payors. Find out what matters to them in terms of quality and outcomes. Find out if you can join one of their pilots for cost-saving programs. Learn how thinking in terms of population health can help. 
  9. Know your practice’s numbers. Physicians who want to stay in practice will need to be able to run the numbers on MIPS and alternative payment models to determine what makes sense for your practice.
  10. Be vigilant. The proposed rule that implements MACRA is expected soon. Keep an eye out for information and education material from AGA. We have been at the forefront on MACRA, advocating for inclusion of specialists in alternative payment models, and we will continue to advocate on your behalf as CMS unveils the new rule.  

More on MACRA

Meet Your 2017 MIPS Reporting Requirements

Sept. 13, 2017

Use AGA Quality Measures and improvement activities and register by Oct. 2 to avoid a payment penalty in 2019.

AGA Comments on Quality Payment Proposed Rule

Aug. 23, 2017

Members helped ensure that CMS heard the voice of GI.

Is a Management Service Organization the Right Fit for My Practice?

Aug. 14, 2017

Partners in Value 2017 speaker Barry Tanner provides details on his talk "Private Equity Firms Building Large MSOs."