The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) completely reforms Medicare payments, linking the majority of fee-for-service payments to value & quality.
MACRA repeals the sustainable growth rate formula, streamlines multiple quality programs (Physician Quality Reporting Program, Value Based Modifier, and Meaningful Use), and links the majority of fee for service payments to value and quality via two payment tracks – Advanced Alternative Payment Models (APMs) and the Merit-Based Incentive Payment System (MIPS).
With only five APM’s currently qualifying as Advanced APM’s the vast majority of APM participants (including MSSP Track 1) and all other eligible clinicians will fall under the MIPS payment model. And the first MIPS reporting period begins January 1, 2017. Regardless of which payment mechanism a clinician or group falls under, risk is now unavoidable and long term success requires continuous improvement in the cost and quality of care.
Success under MACRA will hinge on the ability to maintain visibility into patient care across the continuum, share information, and coordinate care between providers and settings. Infina Connect’s Intelligent Care Coordinator addresses these challenges by:
Impact cost/utilization and quality measure performance.
Improve performance in all four scoring categories & outperform peers nationally.
Expedite the referral process & prevent avoidable hospital admissions.
The community wide visibility and coordination you need to take on risk.
Under MACRA, every eligible clinician is now at risk. How can you manage risk if you don’t know where your patients are? A referral is the trigger point that dollars are being spent, and an early indicator of a decline in health. Each referral represents an opportunity to place the patient with a high value provider. By working together to coordinate care across the community, clinicians are able to manage risk more effectively by maintaining control of the downstream quality and cost of care.
Manage cost by referring to high value partners.
Regardless of the consulting providers EHR.
Electronically exchange C-CDA’s or other clinical documents.
Manage quality with ongoing visibility into patient care.
Coordinate care community wide.
Receive clinical summary & results electronically.