The Tools You Need to Succeed Under MACRA

Is it really possible that some things are getting better? Well, yes, they are.

In October, the Centers for Medicare and Medicaid Services (CMS) issued the first set of rules and policies for Medicare’s new quality and payment programs. These new programs were created by Congress in the Medicare Access and CHIP Reauthorization Act of 2015, otherwise known as MACRA. (“CHIP” stands for the Children’s Health Insurance Program.) The programs represent sweeping reforms in how Medicare will reward psychiatrists and other physicians for the quality of their patient care, and reporting under these new programs begins in 2017. Most importantly, CMS projects that almost half of psychiatrists who see Medicare patients will be completely exempt from Medicare’s quality reporting requirements—and exempt from any related penalties. Those who choose to participate may qualify for substantial bonuses.

Importantly, we know that major insurers often follow CMS’s lead, so that even if you do not see Medicare patients, these payment reforms may have important consequences for you.

Because of the complexity of these new Medicare programs and their potential impact on your practice, APA has created a Payment Reform Toolkit that is designed to make the transition as easy as possible for you. The toolkit, which can be accessed on APA’s website, takes a comprehensive look at these new policies and the details of how they make affect your practice.

Among the toolkit resources are a primer titled “MACRA 101” and fact sheets that address specific parts of the payment reform categories. Now under development are resources for small practices and psychiatrists who work at multiple sites, more information about the exclusion of psychiatrists from these programs, a glossary of terms, and additional information to help members prepare for the transition.

A major part of the toolkit is a series of webinars. These include “Quality Reporting 101,” a basic introduction to reporting quality measures, as well as an overview summarizing these new policies and highlighting key issues and options for psychiatrists. Three webinars focus on different performance categories under the new quality program known as the “Merit-Based Incentive Payment System,” and another webinar summarizes incentives for participating in “advanced” alternative payment models.

Let’s not get too deep into the weeds here—I encourage you to look at the toolkit and come back to the site frequently to take advantage of additional materials that APA has created for you. APA members can also contact our staff experts directly, using the contact information provided in the Toolkit. Our goal is to provide you with everything you need to navigate this system, so that your focus can remain SQUARELY on your patients.

A key point is that while the final Medicare policies represent a win for psychiatrists, most importantly, this is a boon to our patients. We owe it to them to inform ourselves as best we can about these reforms and apply them to maximum effect in our practices so that we can continue to deliver better, smarter, and healthier care. ■