Policy/Regulation Fact Sheet : Impact of MACRA System Implementation

Policy/Regulation Fact Sheet : Impact of MACRA System Implementation

This assignment is a Policy/Regulation Fact Sheet. Must be done in APA 7 format, which includes  Reference in APA7 format.

Solution 

Policy Fact Sheet

Description

The Medicare Access and Chip Reauthorization Act of 2015 repealed the formula connected to Sustainable Growth Rate, which threatens healthcare professional’s participation in Medicare with likely cliff for 13 years (Nelson, 2018). For those participating in Medicare Part B, the Quality Payment Program offers one either the advanced Alternative Payment Model (APM) or the Merit-Based Incentive Payment System (MIPS) depending on the practice size, specialty, location as well as patient population.

Choosing the APM means the clinician may earn incentives for their participation in the innovative payment model while opting for MIPS means they deserve a performance-based payment adjustment. This legislative regulation influences nursing informatics by establishing the Quality Payment Program and transition to meaningful use any one of the parts of MIPS. At the same, MACRA also established a value-based system for CMS payments (Catalano, 2019).

Impact of MACRA System Implementation

Because MACRA is an extensive law, CMS still holds discretion in making particular determinations on the over 300 components of MACRA. According to Jones et al. (2016), neurologists should consider participating in these programs because once implemented, and the penalties continue to pile upwards up to 10% more than Medicare payments

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Impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow

• MACRA, APMS, and MIPS impact on critical care services by having reduced costs (Hobson et al., 2017)
  • Quality and care coordination must be present for improved outcomes and controlled healthcare costs.
• Boosts patient-physician interaction since specialists who do not take part in MACRA risk abdicating their being involved in not only the reimbursement but also care redesign happening around them.
• Ensuring that electronic data is usable as well as interoperable implies improving workflow.
• Mandates the use of certified EHR systems

Organizational Policies and Procedures for the Policy

For successful implementation of MACRA – compliant policies and procedures, the healthcare facility where I work for will adopt the following means.

1. Policies, procedures, and standards of conduct. Next, the facility will designate a compliance office that will be in charge of a compliance committee.
2. Training and education of the staff in addition to the organization having to develop active communication lines (Murrin, 2016)
3. Constant internal monitoring and auditing and ensure the standards are enforced through publicized disciplinary guidelines.
4. Prompt response to detected offenses and appropriate remedial measures taken to enhance MACRA compliance.