Though it may not come as a surprise to anyone who has to deal with it on a regular basis, MACRA (short for Medicare Access and CHIP Reauthorization Act) has created more than its fair share of confusion since it was enacted back in 2015. In particular, the Merit-based Incentive Payment System known as MIPS has been the source of many issues despite its objective of bettering healthcare payment by promoting a value-based reimbursement system. According to ICD-10 Monitor, 80 percent of providers have plans to report practice data under MIPS, but a staggering 75 percent have reported that they don’t fully understand the reporting rules.
Unfortunately, these issues are not likely to end anytime soon. The documents outlining the specifics of these programs are already hundreds of pages long, and they’re only going to keep changing as the programs update and adjust. But until then, over 70 percent of practices report that MACRA does not even support their idea of a quality program because it is not specific to their care specialty and the cost to implement the new changes is far more than many anticipated. In fact, projections estimate that it will cost nearly three times as much to institute a new value-based reimbursement standard as compared to the traditional fee-for-service system.
With so many major changes that don’t seem to result in an initial positive outcome, many healthcare employees are understandably questioning the benefit behind MACRA. Given that such an overwhelming majority of people have expressed confusion toward the rules, there is a high chance that many practices will report their information incorrectly, which in turn will lead to bigger problems down the road. CMS has already discussed the possibility of amending and clarifying some of the rules, but until that day comes, physicians, coders, and billers alike must take strides to familiarize themselves with MACRA rules to the best of their abilities.