Seema Verma, administrator of Centers for Medicare & Medicaid Services.
Copyright ©2016 GreatAgain.gov, CC BY 4.0
Good news for small mental health practices! Centers for Medicare & Medicaid Services (CMS) has released a proposed rule exempting many small clinicians from participating in its MACRA quality performance program.
If this proposed exemption is adopted, it would save small practices a significant amount of time and money. But most importantly, it would help keep solo and group clinicians who participate in Medicare Part B focused more on healing their clients and less on paperwork. Here’s why:
What is MACRA?
MACRA is a program created by CMS to incentivize healthcare professionals to improve client outcomes and encourage professionals to explore non-traditional treatment methods. It applies to clinicians who see patients insured by Medicare Part B. If you are required to participate, you must submit data regarding your clients’ progress, how you used electronic health records (EHR), and how much your services cost to CMS every year. Using that data, CMS creates an evaluation of your performance.
Based on your performance, CMS may make an adjustment to how much they reimburse you for services starting in 2019. That adjustment could be up, down, or none at all. CMS hopes this will encourage clinicians like you to heal patients more quickly, reducing how much Medicare and Medicaid have to reimburse.
Why is this exemption good for small practices?
While participating in MACRA does present the possibility of being paid more after 2019, the amount of time and money that must be spent to fulfill the CMS requirements is not small. And in a recent survey of healthcare providers, “43% said they need help with MACRA preparation, 30% said they are not at all prepared while 27% said they are ready to go.”
With this exemption, small practices like you have a choice. You can decide if the potential upward adjustment is worth the time and money you’ll spend gathering and submitting data to CMS.
What practices would be exempt?
If the proposed rule is adopted, practices with “less than or equal to $90,000 in Medicare Part B allowed charges or less than or equal to 200 Medicare Part B patients” would be exempt from participating in MACRA.
We appreciate the steps CMS is taking to reduce the burden on small practices and allow clinicians to focus on treating their clients. We aim to do exactly that as well with our simple, friendly and responsive practice management application and professional billing services.