A new portal for Medicare Access and CHIP Reauthorization Act (MACRA) reporting has been launched by the Centers for Medicare & Medicaid Services (CMS). Now, providers participating in the Quality Payment Program (QPP) can view their real-time scores as they submit new data in the system within each of the Merit-based Incentive Payment System (MIPS) categories.
We reviewed modern tools and practices that help providers thrive under MACRA and our new value-based healthcare system. Below is a closer look at this new MACRA app for providers, adoption of a patient-centered medical home (PCMH) model, and the leveraging of data analytics to effectively meet payer requirements and provide high-quality care.
A New Web Portal for MACRA reporting Streamlines Data Submission for Providers
On January 2, 2018, CMS made the announcement that QPP participating providers can begin submitting their 2017 performance data on the new website, https://qpp.cms.gov/. Effectively, the QPP reporting for MACRA and meaningful use have been consolidated into one system. The goal of this initiative is to streamline the data submission process to make it easier for physicians to fulfill their MACRA reporting requirements.
Previously under alternative programs such as the physician quality reporting system and electronic health record – multiple websites and systems were used by physicians to submit their performance data. According to the CMS Quality Payment Program Data Submission factsheet (PDF):
“While under the various legacy programs (for example, the Physician Quality Reporting System and the Medicare EHR Incentive Program for Eligible Professionals), you had to submit performance data using multiple systems. However, under the Quality Payment Program, we streamlined the data submission process and created one system for data submission.”
In the official press release, CMS Administrator Seema Verma explains that “the Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to implement the Quality Payment Program, and we are committed to doing so in the least burdensome way possible. The new data submission system makes it easier for clinicians to meet MACRA’s reporting requirements and spend more time treating patients instead of filing paperwork.”
Now that the new system is in place, QPP providers can submit 2017 performance data which runs until March 31, 2018 – with the exception of groups that utilize the CMS Web Interface that must submit between January 22, 2018, to March 16, 2018. Once the clinician is logged into the new portal for MACRA reporting, a taxpayer ID number will be connected to their National Provider Identifier and data will be submitted as either an individual or a group.
Meeting MACRA Requirements While Still Focusing on Patients
How are providers supposed to meet the reporting requirements of MACRA and still provide attentive quality care to their patients? According to an article in Modern Healthcare, a patient-centered medical home (PCMH) model could be a solution to meet the evolving payer needs. As stated in the article:
“The patient-centered medical home (PCMH) model builds better relationships between people and their clinical care teams, as well as between clinicians. This model has been shown to improve quality, reduce costs and improve patient satisfaction – all goals of MACRA.”
The following six concept areas are core to the implementation of a PCMH model:
- Team-based care: Roles and responsibilities must be clearly defined and structured communication is needed to ensure all activities and processes are carried out effectively.
- Know and manage your patients: An efficient process needs to be in place to collect patient information and effectively use that information for the delivery quality care.
- Patient-centered access: Continuity of care in the PCMH model is accomplished by providing patients access to important information and clinical advice via an electronic system – that also allows for communication and refill requests.
- Effective care management: Many patients have medical needs that are quite complex and therefore, they require more intensive support. Healthcare organizations must implement programs to reduce costs and manage the medical needs of such patients.This is accomplished through adequate monitoring and assessment, patient and caregiver engagement, thorough follow-up, and more.
- Care coordination and care transitions: Oftentimes the root cause of preventable readmissions is a lack of coordination and poor communication during a transition period of care. Care should be coordinated effectively among healthcare providers for each facility when applicable (i.e. when a patient transitions from hospital to a skilled nursing facility) and always with the patient, family, and caregivers.
- Quality Improvement: Quality improvement needs to occur on a continuous basis in a patient-centered care model. Hospital data and analytics should be used to identify areas in need of changes in order to improve clinical quality, patient experience, and efficiency. Goals and benchmarks need to be in place in order to evaluate progress while implementing updates.
Leveraging Data Analytics to Meet the Challenge of Healthcare Consumerism
While many hospitals are still stuck in their financial systems that only work in a fee-for-service payment model, forward-thinking healthcare organizations are making use of their data analytics to drive change and improve care delivery. In a recent article in Health IT Analytics, Busy Burr, VP, and Head of Health Care Trend and Innovation at Humana stated:
“Over the next few years, we absolutely have to figure out how to connect our disparate data sources so that we can truly take advantage of the information we’re already generating, not to mention all the new data sources we need to start harnessing.”
[Read also: Patient Needs and Retail Healthcare]
At the SSI Group – we offer robust revenue cycle management software designed to help organizations succeed in the value-based payment model of the future. Learn more about our Analytics 2.0 that helps providers gain access to, analyze, and take action on the information available to their business operations and practices by requesting the form here.