There has been extensive conversation around Meaningful Use (MU) and the passage of Medicare Access and CHIP Reauthorization Act (MACRA). CMS announced earlier in the year a shift from MU to MACRA which streamlines the transition from fee-for-service to value. MACRA highlights three changes in how to pay those who treat Medicare beneficiaries, including:
- Ending the Sustainable Growth Rate (SGR) formula for determining Medicare payments for healthcare provider services
- Making a new framework for rewarding health care providers for giving better care not just more care
- Combining existing quality reporting programs into one new system
As the healthcare industry begins to move towards MACRA– how can providers and payers prepare? CMS outlines the Merit-Based Incentive Payment System (MIPS) as one of the quality programs that enable providers to map back to MACRA.
MIPS is a great program that helps providers evaluate performance from a variety of perspectives as it relates to quality and measure how they are offering care in a meaningful way. With a timeline put in place, how can healthcare organizations lay the groundwork to build towards it? Here are three areas to keep in mind:
- Technical Readiness – Do you have the appropriate analytics platform and metrics put in place? Analytics is the first step towards implementing MIPS. This aligns the organization by establishing benchmarks and goals, along with using data to properly track efforts.
- Collaboration between clinical and business departments – Are both clinicians and the c-suite aligned on results? This conversation is an important one to have. Clinicians and c-suite executives, although envisioning the same goal, have different methods in achieving them. Connecting and establishing a roadmap is crucial to keeping everyone honest and on-track.
- Close-eye on data – Data is key and with an effective analytics program it can shine a light on gaps in care. Data allows organizations to pivot strategies so that roadblocks are less costly and time consuming.
To learn more about how to effectively track towards MIPS – check out our performance management solution.
Get our take on industry trends
The GLP-1 Insights Series, Part 2: Maximizing impact and savings through analytics
GLP-1s present a major opportunity for organizations to improve clinical outcomes and reduce long-term healthcare costs. However, payers and providers…
The GLP-1 Insights Series, Part 1: Long-term impact on costs and outcomes for payers and providers
Few pharmaceuticals have surged in popularity as fast as GLP-1s. This growth is well-justified. GLP-1s, a class of medications originally…
Healthcare Data Interoperability: Why Is Healthcare Still Struggling to Share Data?
Key takeaways from The Sequoia Project’s 2025 Annual Meeting to speed up healthcare data interoperability I recently attended The…
Helping Accountable Care Organizations Navigate the Perfect Storm
In the ever-evolving landscape of healthcare, Accountable Care Organizations (ACOs) find themselves at the epicenter of a transformative era. Recently,…
