Accountable care organizations (ACOs) have been laying the groundwork for the requirements for the Medicare Access and CHIP Reauthorization Act (MACRA), which will give physicians participating in ACOs an advantage during the implementation of the new Medicare payment system, said Katherine Schneider, MD, president of the Delaware Valley ACO.
Accountable care organizations (ACOs) have been laying the groundwork for the requirements for the Medicare Access and CHIP Reauthorization Act (MACRA), which will give physicians participating in ACOs an advantage during the implementation of the new Medicare payment system, said Katherine Schneider, MD, president of the Delaware Valley ACO.
Transcript
How can ACOs help physicians prepare for the implementation of the MACRA final rule?
ACOs are really an important part of the preparation for the change from volume to value, in general, and MACRA is just one piece of that from the point of view of Medicare’s direction. For those of us who have been in ACOs that have been operating for a couple of years, I think we have been laying the groundwork for the requirements of MACRA really effectively, and I can give you an example from the Delaware Valley ACO, where this year we have 650 primary care physicians, we’re in our third year of operation in 2016, and many of the requirements under MIPS [Merit-based Incentive Payment System] and MACRA, we have been prepping our physicians and practices for because they are aligned with the tools you need to have in your tool belt to succeed under value-based care.
So things like, not just having an EMR [electronic medical record], but really optimizing the use of the EMR; where you put your data, really being able to extract data; the patient-centered medical home type of requirements around access, care coordination, proactive panel management and population health management. Those are all the kinds of tools that practices will need to be successful under MACRA, whether or not they’re actually in an ACO in the future. So that’s part 2—clearly being in an ACO or some form of an organized alternative payment model provides advantages under MIPS or MACRA that practices would not be able to achieve on their own, particularly the smaller practices.
So not only are we helping them to prepare in terms of their own processes, but being in the ACO gives some benefits: they don’t have to do their own reporting, because they’re actually already reporting through the ACO, so they don’t have to double reporting, and they receive some extra credit in certain categories for the work that they’re doing through the ACO.
So we want to message carefully to our practices that it’s not just, “Oh, you’re in an ACO, you don’t have to worry about this.” The message is, “You’re in an ACO, you’re already doing this work, and CMS wants to give you credit for the work that you are doing under the ACO model by providing some advantages under MACRA.”
The Pivotal Role of Payers in Improving Health Equity, Maternal Health Care in the US
March 26th 2024A presentation at the Greater Philadelphia Business Coalition on Health's 2024 Women’s Health Summit discussed how payers, including employers and public entities, can strategically influence health care purchasing to prioritize maternal health and equity.
Read More
Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
Listen
Health Equity and Access Weekly Roundup: March 23, 2024
March 23rd 2024The Center on Health Equity and Access covered disparities in hypertension, diabetic eye health, and hidradenitis suppurativa, along with the proposed legislation banning diversity, equity, and inclusion efforts in Alabama schools and the consequences in sickle cell care from the CDC guideline for opioid prescriptions.
Read More
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen