While clinicians may be confused or frustrated with the Medicare Access and CHIP Reauthorization Act (MACRA), professionals in health information management should see it as “nothing but positive” and embrace it, according to Bonnie Cassidy, MPA, principal of advisory services at nThrive and former president and chair of the American Health Information Management Association (AHIMA).
Her presentation at the AHIMA conference in Los Angeles on the changes MACRA brings to Medicare reporting in 2018 doesn’t ignore concerns clinicians have with the new payment tracks. She said they’re looking at it from the perspective of how to earn a positive payment adjustment. For the HIM
professional, however, she said it should viewed as almost the culmination of efforts on clinical documentation improvement
“It’s kind of the glory, getting to appreciate the fact that all that hard work towards clinical documentation integrity results in people using that data,” Cassidy said to Clinical Innovation & Technology. “I personally don’t think it’s a hardship, I think it’s a tremendous opportunity for HIM professionals to learn this and embrace it.”
Learning it was their focus in 2017, with CMS having offered “pick your pace” options rather than a full year of MACRA reporting. Oct. 2 marked the deadline to begin collecting a full 90 days’ worth of data which would allow a clinician to possibly earn a positive payment adjustment.
Cassidy said many HIM professionals had been relatively new to the world of Medicare rules and regulations, with HIM previously having been “acute care focused” and now spreading to physician practices as a result of healthcare’s consolidation trend. Ahead of the second year of MACRA—the first where full-year reporting for the Merit-based Incentive Payment Systems (MIPS) may be expected—HIM professionals have begun to grasp what a major change in data collection and submission these system represent.
Preparations for 2018 reporting have been affected, she said, by the proposed rule from CMS which would exempt far more clinicians from MIPS by raising the program’s low-volume thresholds. If HIM professionals think standards are going to continue to change, she said they’ll “question how real it is.”
“Once we went through ICD-10 and it was year after year after year” of delays, Cassidy said, “it’s the boy who cried wolf. Is it real or is it going to change again?”
She concluded with the hope that HIM professionals come away from her presentation seeing the opportunities with MACRA’s payment tracks and how it helps integrate their skills into healthcare outside of the inpatient setting.
“Because reimbursement has changed and is going to continue to change from fee-for-service to fee-for-value, the real driver in that whole element is health information management,” Cassidy said.