Physicians' Guide to Better Understanding MACRA & the New Medicare Reimbursement Rules

Physicians' Guide to Better Understanding MACRA & the New Medicare Reimbursement Rules

Back in 2015, U.S. lawmakers passed the Medicare Access and CHIP Reauthorization Act, better known today as MACRA. Representing a major overhaul of the Medicare reimbursement rules, the law has been called the "most substantive change to how healthcare is paid for in a couple of decades," as the Locums Link Blog pointed out back in September.

Since then, MACRA has been rolling out as part of a years-long implementation process, with full compliance expected by January, 2019. Yet many questions persist about MACRA, among the many doctors whom it directly affects, as well as the healthcare industry in general.

With that in mind, the experts at Staff Care have released a new white paper to foster a better understanding of MACRA and how to get on board with it. Ranging from a detailed breakdown of the new payment models and scoring system to an in-depth look at how MACRA is likely to affect locum tenens physicians and practices, this brief but white paper is the perfect starting point for doctors and clinicians looking to get ahead of these important new rules. It's available for free; you can get a free copy here.

Free MACRA White Paper

Understanding MACRA: The New Medicare Reimbursement Rules

Central to understanding MACRA, of course, is understanding the two principal payment models that make up these new Medicare reimbursement rules. So, what's the difference the between Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs), and how can physicians determine their eligibility for either category?

MACRA: A New Medicare Reimbursement Method for Physicians: A White Paper from Staff CareFinding the answer to this question means also understanding MACRA's new physician scoring system, a program that assesses physicians with a score of 0 to 100, taken across four categories (Quality, Improvement Activities, Advancing Care Information, and Cost).

To underline just to what extent understanding MACRA is a fluid, ongoing process, the white paper authors note that "CMS intends to adjust the score weights and nature of these categories every year to adapt to providers’ changing performance." In other words, the extent to which each of these categories contributes to a physician’s overall score is bound to change, in an effort to fine-tune the process in the face of real-world application. As of 2017, though, Quality comprises the lion's share of a physician's MIPS score, at almost 60% of the total.

Though doctors who work in private practice will almost certainly have to deal with these new Medicare reimbursement rules, hospital-employed physicians are less likely to encounter MACRA in their day-to-day lives. Because of this, our MACRA white paper authors point to the possibility that "more physicians will opt out of private practice, where the compliance burden is highest," and instead choose to work as employees or as locum tenens physicians.

Like hospitals, locum tenens agencies such as Staff Care give doctors the chance to work without billing Medicare directly, exempting them from an extra layer of administrative burden while giving them the time and freedom to focus on patient care — or whatever aspect of physician employment they find most rewarding.

If you're currently in the position of dealing directly with Medicare reimbursement, we encourage you to download your free copy of our MACRA white paper, where we'll walk you through each of the key points and categories, step by step, with brief, to-the-point summaries of important takeaways. Or if you're a physician looking to ease your administrative burden and embrace a practice style that maximizes your freedom and flexibility, we invite you to connect with a Staff Care recruitment professional here, or view all of our available locum tenens jobs here.

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