MACRA and CCM: How IT leaders can deliver value

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which aims to replace the volume-based era of healthcare with value-based medicine, may not take full effect for another three years in terms of financial impacts, but the performance measurement period is quickly approaching, beginning this coming New Year’s Day.

As organizations prepare for MACRA, it’s essential to take into account how requirements can be met through chronic care management (CCM) programs – a CMS initiative to help providers bridge the gap between fee-for-service and value-based care by emphasizing care coordination between providers. While technically separate initiatives, CCM programs are an underlying component of MACRA, practically driving what the regulation is aiming to achieve: a push toward truly value-based, patient-centric care. It is, after all, nearly impossible to meet the requirements of MACRA without also performing the tasks of CCM.

IT leaders, especially in mid-sized or larger group physician practices, play a key role in preparing their organizations by ensuring all tools and infrastructure are in place now to meet basic CMS requirements for care coordination and value-based care. In doing this, IT leaders have the opportunity to lay the foundation for a truly effective CCM program – that benefits the financial health of the organization and, more importantly, the physical and mental well-being of its patients.

Regardless, time is of the essence: For every day that physician practices fail to meet care coordination requirements under the MACRA performance period, currently scheduled to begin in 2017, they risk a reduction in Medicare reimbursements beginning January 2019.

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care coordination, CareSync, CCM, chronic care management, MACRA, Medicare Access and CHIP Reauthorization Act of 2015, Merit-based Incentive payment system, MIPS


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