MACRA Solutions

The Medicare Access and CHIP Reauthorization Act (MACRA) was enacted in 2015 with the goal of creating a flexible, unified program for reimbursing physicians under two value-based payment tracks – the Merit Based Incentive Payment System (MIPS) and the Alternative Payment Model (AMP)

According to, the purpose of MACRA is to create a quality based payment program that:

  • Repeals the Sustainable Growth Rate formula
  • Changes the way that Medicare rewards clinicians for value over volume
  • Streamlines multiple quality programs under the new Merit Based Incentive Payments System (MIPS)
  • Gives bonus payments for participation in eligible alternative payment models (APMs)

Beginning next year in 2019, physicians that achieve the highest scores will be eligible for positive adjustments in payment under Medicare Part B. Likewise, physicians with low scores will receive a negative payment adjustment. For medical businesses, this means that the time to start preparing for MACRA is today.

Contact the Centers for Medicare & Medicaid Services (CMS)

If you’re a physician with a specialty designation, your first step in preparing for MACRA should be to contact CMS and ensure that they you’re listed with them under the appropriate specialty. This one step will save time and possibly frustrations once assessments begin. You want to make sure that you’re being compared against other practitioners within the same specialty.

Make the Time to Meet with Administration

Physicians that are associated with a specific practice or hospital should make plans to have a meeting with the appropriate administration to outline their approach to MACRA preparedness. This is a crucial step for identifying what steps need to be taken to become MACRA compliant and develop a realistic, goal centered timeline for implementation.

Understand the Impact of MACRA on Your Medical Business

Some medical businesses, specifically those that treat a smaller number of Medicare patients may be exempt from MIPS. If your business submits less than $30,000 per calendar year in Medicare charges, you meet the exemption status. Since smaller medical businesses often don’t have a clear picture of how large their Medicare patient base actually is, now is the time to look at the number of Medicare patients treated per year, and the total sum of their Medicare charges.

Clinical Practice Improvement Activities (CPIA)

MIPS contains a category for improvement activities that are used as a base of measurement of your involvement in the improvement of your medical business. While businesses are allowed to choose from activities in the improvement inventory, many might be surprised to discovery that they are already participating in acknowledged initiatives or just need to make minor adjustments to their current system or structure of practice. If you haven’t already, now is the time to familiarize yourself with the CPIA activities and develop a plan of action.

Consider Specialized Practice Management EMR Solutions

An EMR solution can help improve performance scores by streamlining some of the processes that MACRA looks at. For example, providing patients with electronic access to medical records is a positive MACRA action, as is providing patients with the ability to receive electronic prescriptions and the having the tools to easily exchange crucial medical information with other facilities.

We offer the specialized EMR solutions that will relieve some of the stress of preparing for MACRA. Now is the time to be looking at how to adapt and which solutions will improve your quality score. Contact Raintree Systems today to learn more about how we can help you prepare for MACRA.