Medicare Reporting Challenges to Impact Independent Practices in 2018


Independent medical practices across the country brace for another series of changes from the Centers for Medicare and Medicaid Services: new legislation, performance-based incentives and reporting requirements, compliance demands, more inpatient codes, and astonishing cuts to Medicare physician fee payment rates. Private practices across the country stand to lose the most:

  • Today 59% of physicians are not taking advantage of the benefits of MACRA due to the complex reporting requirements for the performance-based incentive payment system.

In a “damned if you do, damned if you don’t” scenario, these independent medical practices are already struggling with the administrative demands of primary care and chronic care management. Overburdened by intense Medicaid reporting requirements, implementing these changes would require an overhaul of both administrative and patient care workflows.

2018 Medicare Changes Will Impact Primary Care Access

Provider-owned practices in metropolitan areas are already facing administrative burdens as they compete to provide care against on-campus hospital departments. Those practices that will suffer the most are the independent medical practices in “healthcare deserts” -- underserved communities who do not have easy access to hospitals, primary care, or effective chronic care management.

These practices are currently overwhelmed by the sheer number of patients they serve. The proposed Medicare cuts are “yet another blow to access to care for patients, including many vulnerable communities without other sources of healthcare,” said Tom Nickels, executive vice president of the American Heart Association of the CMS announcement.

Making changes to their entire workflow to accommodate MACRA’s new reporting requirements to offset the impending Medicare cuts would require more staff, more money, and more time that independent medical practices don’t have. It’s no wonder that the U.S. is facing a shortage of 90,000 doctors by 2025, with 9 in 10 physicians reporting that they’re unable to recommend the profession to others.

A Lifeline for Doctors and Patients: Data-Driven Healthcare

Despite these changes, data-driven practitioner groups presently have the ability to understand and track all the elements of care, including price and outcome, and consistently strive to improve by creating benchmarks for success. This is achieved by eliminating tedious manual aspects of their administrative workflows -- accomplished without hiring additional staff and taking on more patients to reduce the financial impact on the practice, effectively ending the cycle that was overburdening them to begin with.

By leveraging third-party solutions that combine technology and decision support, these practices can produce scalable, high-touch care models that allow them to fulfill MACRA’s requirements with ease of documentation and reporting, providing improved patient-provider experience and reducing cost of care.

These automated workflows make it easy for doctors to track referrals and communicate with at-risk, poly-chronic patients electronically. Reports detail MIPS key performance indicators across Annual Wellness Visits, Chronic Care Management, Post Acute Care, and Transitional Care Management so practices can take advantage of the MACRA performance-based incentive system.

How to Offset 2018 Medicare Physician Fee Payment Rate Cuts

Physicians must report all required measures to be properly scored for their MACRA reimbursements, which will be even more critical given the 2018 cuts. This requires the use of an electronic health record system and transparency in Medicare reporting. Oculus Health works with primary care practices’ existing workflows to combine technology and decision support.

By equipping private practices with the tools independent medical practices need to be effectively transparent in their activities, they are able to be properly compensated, grow their business, serve more patients, and provide better quality of care. Learn more about how you can dramatically reduce administrative costs and overhead with simplified documentation from Oculus Health.

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