aco decisions impact provider macra revenue

Analyzing the financial MACRA impact of the new ACO regulations is daunting.  You could build spreadsheets.  

Or you could simply ask our expert software.  


We have a simple, quick and inexpensive approach


MACRA Monitor automatically loads all the providers for each TIN from the PECOS Database.  It also collects Medicare Part B billing history from CMS.  We pull CQM data from your public reporting website, to baseline on MACRA Quality.  We apply base and bonus threshold, CMS Scaling Factors, and annual scoring rules, and compare  MIPS adjustments based on Adanced APM, MIPS APM and Group vs Individual models.


In the bigger picture,  MACRA revenues can be the equivalent of MSSP Shared Savings (or  MSSP SharedLosses) as well.  

We have built a simple, downloadable spreadsheet to help analyze how your providers may se MACRA financials, as compared to MSSP financials.  

Compare MACRA Revenues to MSSP Revenues

ACO Service Offerings

$1,000 Quick Assessment

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ACO-Level Data 


For each TIN, and each provider, see MACRA reimbursement under each option:

Advanced APM (Enhanced or Level E)

MIPS APM (Basic levels A - D)

MIPS Group (Non-ACO)

MIPS Individual (Non-ACO)


Projections based on most recent public ACO CQM scores, with category scores for PI and CPIA from recent submissions.  

$3,000 Full TIN Level Data

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ACO + TIN-Level Data


Same as Quick Assessment, plus CQM data from each TIN (for up to 30 TINs).  Our concierge will coordinate with each of your TINs to collect current-year content from CEHRT (or from prior year QPP Submissions).   During PI and CQM data collection activity, we can obtain "most likely" CPIA activities as well.   


Bottom line is fully customized MIPS Score for each TIN, to include their own e-CQM and PI scores independently drawn from CEHRT.  


 

MACRA Advisory Support

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Coordination and Communication - Across all TINs


Our team of experts is with you for every step.  We have pre-drafted e-mail text to kick off the assessment with your TINs.  We will meet with each TIN separately, or in small groups to educate and gather data.  


No one on your team, or in your TINs does work outside what would be reasonably a part of what you should be doing in the normal course of MACRA business.  We carry the work burden for you.  

Reconcile your providers with QPP for $500

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You know which providers and TINs you expect to be part of your participation list.  But QPP sometimes has a different opinion!  We will reconcile every single provider and TIN against QPP, and provide the results in a database or spreadsheet format. $500 for up to 30 TINs.  


Why bother? Because if you assume a provider is part of your ACO, and QPP does not show them so, you could expose that provider (or TIN) to reduced reimbursement, or even penalty. 


Monthly MACRA for ACOs

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2019 hits clinics - and ACOs - harder than prior years.  Our premier offering for Monthly MACRA will optimize PI, CQM and overall MACRA reimbursement.  In the process, our monthly supportive interactions with each TIN in your ACO will improve provider engagement.  


Monthly MACRA includes our top-notch MACRA support team, ACO-level MACRA reporting and financial analysis, CQM Improvement, Security Risk Assessment ... virtually everything your providers need for Optimization of MACRA revenues.  At year-end, we will even submit MACRA data on behalf of all your providers.