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Mar 28

ACA vs. AHCA vs. MACRA/MIPS

There have been a lot of changes in how our healthcare has been delivered over the past few years, and the recent administration changes have shown our ride is not over.  We have received a lot of questions at ReportingMD about how the changes to the Affordable Care Act (ACA), the new American Health Care Act (AHCA), and the MIPS program all relate to one another.  As a population health company that has been around for over 10 years, we have seen differences in healthcare and the way it is managed.  Providers and Administrators are seeking our input on how to handle the perspective AHCA and potential changes to the MIPS program.

Based upon the research and what we hear from CMS, we see very little changes coming to the MIPS program under the new administration.  MIPS streamlines 3 pay-for-performance programs into 1 and adds an additional subject that is intended to promote continuous improvement for providers and practices nationwide.  PQRS, Value Modifier, and Meaningful Use were sun-setted and emerged into the MIPS program.  The federal government had to make changes to these programs in order to consolidate the rapid growth in expense of federally funded healthcare for Medicare/Medicaid.  ACA and AHCA are different forms of legislation compared to the MACRA program and provide avenues of affordable healthcare to individuals.  MIPS is how we get our care, while ACA/AHCA is how you can acquire coverage for that care.

We applaud CMS for taking a hard stance in the quality of care that is delivered to the greater population.  Providers are now required to attest to the programs and quality of care that they practice on a daily basis.  Fee schedules are going to be affected starting in 2019 for decisions that are made throughout organizations in 2017.  The bottom line is this, get ready for the new normal of accountable care providers appropriately managing patient populations.  There are strategies in place to help you succeed, and it is worth investigating those now before it hurts your wallet later.

MIPS program management and guidelines can be overwhelming, but consultative experts and the right CMS-qualified registry can help guide effective MIPS compliance. Ask about ReportingMD’s TOM solution which is already integrated with MicroMD. For more information, contact John Webb, MicroMD Client Insights Manager, to discuss how you can be successful with MicroMD and ReportingMD at your side.

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