MACRA Impact on EHRS

As the government has rolled out MACRA Merit-Based Incentive Payment program, clinics and hospitals are preparing for the major shifts in how they are paid. If the organization already has the Meaningful Use certified platform, they are close to being able to be successful in the new endeavor.

The MIPS program rolls up the MU, Physician Quality Reporting System, and Value-Based Modifier programs. Instead of pursuing all three, the clinic can focus on a strong MIPS score which will encompass all the above.

The MIPS program is made up of four performance categories, although only three currently factor into the score. These include Quality, Advancing Care Information, Improvement Activities, and for future years, Resource Use.

The Quality category represents that largest portion of the provider’s score. The systems in place at the clinic will make a big difference in the final score. They will need to be on MU Stage 2 software to report for the ACI category. Additionally, their score will be based on the performance in each category. Unlike previous programs, they will not be scored on a binary Yes / No system.

As Medicare often drives payment changes for the industry, it’s critical that clinics seriously consider how to be successful in this new program. Even with changes coming soon for the industry, it is likely the the principles of quality-based payment and appropriate resource use (cost) will continue to stand.

Additionally, clinics will need to be considering options for Advanced Alternative Payment Methodologies, as that will be an important aspect of the near term changes to the CMS payment process.

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