When you take into account the general complexities of MACRA, and the extensive amount of data, technology, and transformation that needs to occur, small medical practices just don’t have the human or financial resources to handle the transition easily.
The payment adjustment formula is complicated. Small practices need to understand which levers they should pull to maximize their reimbursement. Since the MIPS/APM program is highly flexible with several pathways, there is much room for confusion. It can be challenging for Physicians in small practices to determine their next steps. Additionally, in contrast to larger clinically integrated health systems, most small practices lack the resources and expertise necessary to drive performance toward value-based care in critical areas such as:
- Patient Quality and Safety management
- Care and utilization management
- Data Informatics & analytics
- Team-based care model implementation like a Patient-Centered Medical Home
- Full spectrum network of specialist
- Home Health, Skilled Nursing & Hospice Care
Despite these challenges, there are some important actions that Physicians and administrators in small practices can take.
The key to improved patient outcomes is focusing on capturing the right data in real-time that is accurate and relevant and using that data to create knowledge to drive action. Whether you partner with experts in the field or go it alone, you need to evaluate your population health, EMR and data strategies. An experienced partner should truly understand the challenges you face and provide solutions that meet your unique needs.