MACRA and Risk Assessments

The final rule for MACRA, the Medicare Access and CHIP Reauthorization Act has been put into place. It establishes quality measurements, and two payment models for Medicare, the Quality Payment Program.  This rule expands flexibility for small medical practices, making it easier to transfer to, and work within the MIPS program. MIPS stands for Merit-based Incentive Payment System. It is one of two Medicare reimbursement tracks, the other being an advanced alternative payment model (APMs). In MIPS, physician pay will be based on success in four performance categories. As one of these categories includes Risk Assessments, conducting one remains a vital neccessity for any medical practice.

The article “Risk analysis could trip providers up under MACRA” on Health Data Management elaborates on this further:

Tennant emphasized there are four crucial areas to which providers now must pay attention: risk analysis, electronic prescribing, patient access to their data and health information exchange via sending summary of care documents to another provider. Failure to meet these baseline requirements will result in no points being granted to providers, and the point system being used will affect provider reimbursement from Medicare—the more requirements providers meet, the higher their Medicare payments can be.

Conducting a comprehensive risk analysis to identify security vulnerabilities, document improvements and justify why certain improvements were not made is a particularly critical part of complying with the law, Tennant warned. Not conducting a risk assessment is the leading cause of failing an electronic health record Meaningful Use audit. And most small physician practices still do not understand the new rules.

Read the whole article at HealthData Management.

Industry experts all agree that a risk assessment is the foundation for HIPAA compliance, especially for smaller practices. A risk assessment is a powerful tool that can help your medical practice in every way, and one of those ways is letting your practice achieve positive payment adjustments under MACRA.

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