Dr Katherine Schneider: ACOs Have Laid Groundwork for MACRA

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.

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.”
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