MCMS Physician Summer 2017 - 21

mon t m e d s o c .c om

MACRA
BY JAAN SIDOROV, MD

Reprinted with permission by Pennsylvania Physician, Spring-Summer 2017 magazine.

PAMED stepped into the forefront of new ways of

improving care for Pennsylvania patients. To better reflect patientcenteredness, the Care Centered Collaborative (CCC), PAMED's
new subsidiary, offers practical tools to navigate value-based care.
Job No. 1 for the collaborative is to help Pennsylvania physicians
successfully participate in the Medicare Access and CHIP
Reauthorization Act (or MACRA for short).
The historic MACRA of 2015 consolidated a number
of quality improvement programs that had been previously
established by the federal Medicare program. Under MACRA,
physicians are obliged to use a more centralized system to submit
measures of health care quality to Medicare, which will then be
used to adjust physician payment levels beginning in 2019 (2019
adjustments will be based on 2017 performance).
MACRA is different than the Affordable Care Act and,
thanks to significant bipartisan support in Congress, is destined
to remain the law of the land. The impact of MACRA cannot
be underestimated. If physicians elect to not submit any quality
data, their payment levels will be reduced by 4 percent. This will
further impede their ability to provide access to Pennsylvania
patients and could drive some physicians out of business.
Alternatively, physicians who successfully participate in the
MACRA program will avoid any reduction in their Medicare
payments and, depending on the level of data they submit, could
obtain additional levels of payment that could increase access to
care and further support the provision of high-quality care in the
commonwealth. The CCC has established a relationship with a
MACRA service provider that can offer turnkey access to MACRA
reporting. This includes favorable pricing for PAMED members,
tailored support services, and the ability to benchmark the quality
reporting to national standards.

As a result, participating Pennsylvania physicians will be
recognized for quality. Pennsylvania patients will be aided by a
payment system that fosters greater quality and assures greater
access to care. That's because evidence shows that physician-owned
practices provide superb levels of care for their patients but have
struggled to document and be compensated for them. As MACRA
both recognizes and rewards physicians for this care, the additional
financial support from Medicare will translate into greater
investment in local health care, which means greater access for
patients. While the CCC is launching MACRA/MIPS reporting
services, its board and the management team are also hard at work
developing other services that will ultimately benefit patient care.
Examples include the resourcing of insurance claims payment and
appeals services, offering back-office options to improve various
business functions, and increasing access to a wider array of
insurance services.
The CCC is also pursuing the creation of clinically integrated
networks (CINs) that can increase clinical efficiencies through the
dissemination of best practices, leverage the role of local physician
leadership, enhance the role of data to create actionable patient
care insights, and promote health care teams not only in the clinic
but in the community. We've met with a number of physician-led
organizations that have already done important work in this area,
and the collaborative is dedicated to "doing what it takes" to help
these organizations succeed. More information is available at www.
patientccc.com or (866) 441-2392.

Jaan Sidorov, MD, serves as CEO of the Care
Centered Collaborative.

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Table of Contents for the Digital Edition of MCMS Physician Summer 2017