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    How to manage hepatitis C patients under MACRA

    Screening patients for hepatitis C and discussing treatment options are both important from a clinical standpoint. These tasks can also help physicians score highly in the Medicare payment reform program known as the Medicare Access and CHIP Reauthorization Act of 2015  (MACRA).

    In particular, MACRA’s Merit-based Incentive Payment System (MIPS) track provides physicians with either a bonus or penalty starting in 2019, depending on the quality data related to hepatitis C and other diagnoses that they submit. MIPS measures for hepatitis C are relatively easy to satisfy, with the help of technology and a willingness to communicate with sensitivity. 

    They include:

    • Annual hepatitis C virus screening for patients who are active injection drug users
    • Discussion and shared decision-making surrounding treatment options
    • Screening for hepatocellular carcinoma in patients with cirrhosis
    • One-time screening for hepatitis C for patients at risk (i.e., those with a history of injection drug use, those who received a blood transfusion prior to 1992, those on maintenance hemodialysis, or those who were born between 1945 and 1965)

    Through better documentation and collecting the right data —likely for things they are already doing—physicians can not only avoid a payment reduction from Medicare, but also possibly earn bonus payments.


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