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    7 things physicians need to know about MACRA proposed rule

     

    Here is a brief summary of how physicians will be scored on these categories, and what work it will require on the part of the physician, according to a CMS fact sheet:

    Quality: This is essentially a modified PQRS. Physician would choose six quality measures to report on from a list of options tailored to specialty and practices. Currently PQRS requires physicians to report on nine quality measures.

    Advanced care information: This is meaningful use, but with some new flexibility. Under the new program, physicians will get 50% credit simply for attesting. The rest of the score (in fact physicians can exceed the maximum score) will be based on  performance on measures that cover categories such as patient electronic access to health information, care coordination and patient engagement and electronic exchange of health information.

    Clinical practice improvement activities: Physicians will need a score of 60 points in this section by participating in programs to improve their practices in the areas of care coordination, patient engagement and patient safety. Activities are worth either 20 points or 10 points, with higher-weighted activities contributing to those that support the PCMH model or practice transformation . There are more than 90 choices for physicians to pick from, in these 9 categories:

    • Expanded patient access
    • Patient engagement 
    • Achieving health equity
    • Population management
    • Patient safety and practice assessment
    • Emergency preparedness and response
    • care coordination
    • participating in an APM, including a PCMH
    • integrated behavioral and mental health

    Cost: This replaces the value-based modifier. The good news is that there is no extra work for physicians; CMS will calculate these scores based on Medicare claims.

    Next: APM route

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    • Anonymous
      It will likely take 1 high salaried or 2 low salaried employees to do the required documentation for this nonsense. Another nail in the coffin for private practice. However, even very large group practices will struggle to meet these requirements.
    • Anonymous
      It will likely take 1 high salaried or 2 low salaried employees to do the required documentation for this nonsense. Another nail in the coffin for private practice. However, even very large group practices will struggle to meet these requirements.

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