Medicare Reporting Challenges to affect Independent Practices

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Medicare Reporting Challenges to affect
Independent Practices

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Private practices across the US are bracing for
another series of changes from the CMS (Centers
for Medicare and Medicaid Services). Changes like
new legislations, more inpatient codes,
compliance demands, cuts to Medicare physician
fee payment rates and performance-based
incentives and reporting requirements will be
impacting the bottom line of many private
practices across the country. Due to complex
reporting requirements for the performance-based
incentive program, many physicians will not be
able to take advantage of MACRA (Medicare Access
and CHIP Reauthorisation Act). Also, many
physicians practicing in independent practices
will get to see their Medicare physician fee
payment rates slashed by half this year.
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There are two payment structures under MACRA-
Advanced Alternative Payment Models (APM) and
Merit-based Incentive Payment System (MIPS). As
far as the financial impact of MACRA is
concerned, smaller practices will feel the
maximum pinch. To avoid getting penalised and
benefit fully from the Medicare Access and CHIP
Reauthorisation Act, providers will have to work
issues like care co-ordination and
decision-making into the normal practice
workflow. In order to implement the changes
brought in by the CMS, practices will be required
to do an overhaul of administrative as well as
patient care workflow. Considering that private
practices are already overburdened by the
Medicaid reporting requirements, they will
require more staff, money and time to offset the
impending Medicare cuts caused by MACRA.
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To overcome these challenges, private practices
will be required to track and understand all
elements of care, including price and outcome.
They will have to eliminate tedious manual tasks
related to their administrative workflow by
hiring experienced staff and streamlining vital
business functions. Practices will also be
required to take on more patients in order to
reduce the financial impact. To offset
Medicare physician fee payment rate cuts,
providers will have to report all required
measures to be properly scored for MACRA
reimbursements. This will become even more
critical given the reimbursement cuts expected in
2018. It will require them to make effective use
of EHR (Electronic Health Record) system and to
ensure transparency in Medicare reporting. Some
private practices have started leveraging third
party solutions to produce scalable care models.
With ease of documentation and reporting, they
are finding it easier to fulfil MACRAs
requirements. It has also enabled them to improve
the patient-provider experience and reduce cost
of care.
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