MACRA Hits Harder in 2019 (for Everyone)
But that is good news for those who can do well
In 2017 and 2018, CMS set a low bar, and providers easily cleared it. That meant two things. First, the "budget neutral" pool of funds received very little money that would be distributed. Second, the exceptional performance pool was spread thin across a very high number of providers. In 2019, we should expect that good and top performers will start to receive money more nearly commensurate with their performance.
Our recommendation on achieving good performance is based on a Monthly MACRA program. The program works equally as well for ACOs as for Standalone Clinics.
Of course, a solid program should include more than just monitoring. When shortfalls occur, you should offer providers processes to improve CQM scores and selection (as well as PI). And if you can streamline Security Risk Assessment, everyone benefits.
Even more important than the money - Public Disclosure!
Starting in 2019, CMS will be publicising performance scores to Medicare Beneficiaries (and anyone elsw
interested in evaluating one provider against another). And lest you think the disclosure will be obscure, obtuse and inaccesible, take a look at the CMS video describing how it will all work.
A big part of the solution is monthly Macra management
You can't optimize MACRA at Year End
Improving MACRA Metrics comes from a regular program, throughout the year. We get started as soon as a full month's data is available, and follow a regimen of extract, report, analyze and plan and act for every month thereafter.