macra financial dashboard enables new strategies

2025 presents new MACRA strategies, that depend on near-real-time data.  But how can you evaluate strategies without a financial model?  We make this a core offering, from initial contract, through year-long optimization work.

Part 1: Summarize provider eligibility

Our MACRA Monitor data base automatically queries CMS to  pull a complete list of providers based only on knowing a TIN name, with no intervention from the TIN.  In most cases, this list is more accurate than data provided by the client directly, since it leverages the quarterly eligibility updates on CMS QPP database. 

Part 2: Estimate Medicare revenues and payments

For each provider, we query CMS.Data.Gov for annual  Medicare payments at the provider level, and calculate those payments at the TIN level.  

Part 3: Estimate MIPS Implication

Our tools use metrics CMS publishes each year in the Federal Register that estimate annual maximum MIPS reimbursement.  We start with that value and add in your (and our) judgement call on what MIPS score is realistic based on our experience with other similar clinics, and applying the complex MIPS scoring rules. 

Part 3:  Financial Analyses

Once we know provider eligibility to receive MIPS payments, an estimate of the maximum annual reimbursement and a pragmatic estimate of a TIN's MIPS scores, we create a profile of what is a realistic range for reimbursment.  This helps each TIN make an informed decision on the value of a contract for MIPS services - as well as an indication on the value of effort they put into improving their historical scores.