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MACRA 101: What is MACRA and the two payment models

MACRA 101: What is MACRA and the two payment models

MACRA is the Medicare Access and CHIP Reauthorization Act of 2015, which was finalized on October 14, 2016. MACRA is Medicare’s most recent initiative to directly tie Medicare payments to patient quality outcomes since the Department of Health and Human Services (HHS) began launching quality initiatives in 2001. MACRA’s first performance year begins January 1, 2017 and will have a significant impact on all healthcare providers’ reimbursement. It is more important now than ever before to take the appropriate steps to maximize your potential for increased revenue and mitigate your risks of payment decreases.

There are two payment models presented in MACRA:

  • Advanced Alternative Payment Models (Advanced APMs)
  • Merit-based Incentive Payment Systems (MIPS)

Click here to learn more about these two payment models and the MIPS Scoring Methodology.

Physician Practice Revenue Cycle Services

  • IT Solution Featuring Electronic Medical Records
  • Revenue Cycle Staffing
  • Claims Processing
  • Accounts Receivable Management
  • Patient Billing
  • Payment Processing
  • Monthly A/R Closeout Reporting
  • Certified Coding Oversight

Practice Management Support and EMR Solutions

  • Electronic Medical Records
  • (EMR) Vendor Review
  • EMR Selection, Implementation and Management
  • IT Solutions
    • PMR-EMR-HER
    • Selection of PM/EMR Solution
    • Request for Proposal Development
    • Vendor Evaluation
    • Contract Negotiation
    • Implementation of PM/EMR

Physician Practice Management / Administrative Oversight

  • Administrative Oversight- Administrative Consulting Services to Support Practice Leaders
  • Financial and Operational Consulting
  • Human Resources Services
  • Coding, Billing, Corporate Compliance including ICD-10 Implementation and Training
  • MACRA/MIPS

Medical Services Organization (MSO)

  • Physician Practice Billing/Collection Services
  • Benefits and Human Resources Services (HRO/PEO)
  • Physician Practice Management and Administrative Oversight
  • Coding/Compliance Services
  • Practice Management Consulting, as needed
  • Outsourced Accounting
  • GPO

Physician Business Solutions Leader
 

Andrew McDonald
Andrew McDonald, FACHE

Shareholder-in-Charge, Physician Business Solutions, LLC and Healthcare Consulting
615.309.2474
amcdonald@lbmc.com

We cure business ailments with a delightful bedside manner.

Relieving the burden of business procedures from medical organizations is a gift. One we’ve perfected to a tee. But even with all our healthcare experience, no enhancement would be as effective without the spoonful of sugar we call personal service. It’s as important as our expertise. And it’s part of each and every interaction.

At issue
A new physician partner practice is looking to grow their business with hopes of selling in the future. Their focus is practicing medicine, not doing paperwork. They do want to create a large support system while remaining nimble in the market.

The solution
We stepped in with a complete Central Back Office (CBO) system that provides billing, provider enrollment credentialing and other administrative services more efficiently and effectively than they could on their own. It’s a seamless solution that frees doctors to spend more time with patients.

Are you ready to start a conversation?