MACRA: A chance for hospitals, health systems to lead

erikjohnsonheadshotInitial reactions to the final rule for implementing the Medicare Access and CHIP Reauthorization Act (MACRA) were positive.

Now health care leaders are poring through the 2,300+ page rule to find deeper insights for physicians and physician practices.

Once the full impact of the rule is understood, physicians may need assistance managing the transition. That gives hospitals and health systems the chance to lead.

Physicians by and large don’t want to deal with the hassle of satisfying MACRA requirements.

They will likely be looking to hospital partners for help on meeting the stipulations of MACRA’s various payment models.

Jay Hazelrigs, vice president and lead actuary at Optum®, says MACRA will be an uphill battle for providers.

“This situation practically begs for a strategy where health systems help physicians,” says Hazelrigs. “This has the potential to be mutually beneficial.”

Hospital and health system leaders should ask themselves how they can help physicians adopt alternative payment models (APM).

Consider questions like:

  • What models do you bring to the table?
  • Can you deliver on an advanced APM model?
  • Can you set up a management services organization model to aggregate and execute on the reporting requirements in the Merit-based Incentive Payment System (MIPS)?

Read more about MACRA and its potential impact on relationships between physicians and health systems in the latest episode of #5in5.

In five minutes you’ll read about the affect on consolidation and referrals and learn about the capabilities hospitals need to be good resources for doctors.

The #5in5 series features experts answering five questions in five minutes on changes in the health care industry. Click here to view the entire #5in5 library.


About the Author:

Erik Johnson, VP for Health Management Consulting.

Erik has broad experience in designing population health strategies for a broad array of providers. He was most recently Senior Vice President at Avalere Health, where he ran its Healthcare Networks consulting practice and oversaw new product development. Erik assisted healthcare systems in determining how to adopt and assess accountable care and bundled payment models, and guiding overall strategy. Erik also worked with health IT companies in responding to emergent issues around EHRs and data exchange.

Erik has an BA with honors and distinction from Stanford University and an MBA from the Stanford Graduate School of Business.

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