United States

Health care industry issues and insights webcast series: Part 2 recap

MACRA: Potential impacts to health systems and physician practices


How is the Medicare Access and CHIP Reauthorization Act (MACRA) affecting health systems and physician practices? In our second webcast in the Health care industry issues and insights series, presenters focused on:

  • MACRA overview
  • Merit-based incentive payment system (MIPS) summary
  • Advanced alternative payment model (APM) discussion
  • MIPS and APM self-assessment and strategic preparation

Key takeaways from the presentation include:

  • MACRA through MIPS provides a budget neutral adjustment to professional service payments based on a composite score
  • Those who participate in the most advanced APMs may be determined to be qualifying participants (QPs), and as a result, QPs:
    • Are not subject to MIPS
    • Receive 5 percent lump sum bonus payments for years 2019 through 2024
    • Receive a higher fee schedule update for 2026 and onward
  • Key steps health systems and physician practices should take to strategically prepare include:
    • Evaluate MIPS versus APM track starting in 2017
    • Take advantage of the leniency in MIPS requirements for 2017
    • Review and align physician and provider compensation agreements
    • Review quality and resource use reports and metrics to understand current quality and cost performance for your organization in relation to peers
    • Prioritize your data warehouse capabilities for analytics and reporting on quality, utilization and cost needed for the MIPS and APM tracks
    • Start the journey to value-based care and alternative payment models with respect to readiness, even if it is not an immediate objective for your organization
    • Begin an organizational readiness and network assessment for population health management and value-based care models
    • Plan for an investment in a population health infrastructure
    • Optimize your electronic health record systems

For more information, watch the webcast. In addition, read additional RSM health care industry business insights.


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