Implementation of the Medicare Access and CHIP Reauthorization Act not only marks a new era in provider reimbursement, but it also will likely lead to significant shifts within the overall healthcare system, according to a recent whitepaper from Leavitt Partners, a Salt Lake City-based healthcare intelligence firm.
"New payment models that tie reimbursement to quality and cost performance rather than only volume will not only affect Medicare-enrolled providers, but all providers as alignment of payment models filters throughout the industry," David Muhlestein, PhD, Leavitt Partners' vice president of research, said in a statement. "While MACRA incentivizes providers to change the way they deliver care, many providers still don’t comprehend how to fully shift toward alternate payment models. In order to successfully participate, providers need to evaluate their organizational capabilities, identify where gaps exist and gain the necessary resources."
Here are three ways Leavitt Partners predicts MACRA will change health systems, according to the whitepaper.
1. Acceleration of the transition to value-based care. Leavitt Partners believes MACRA will hasten the end of fee-for-service medicine across all payers, not just Medicare. "Allowing providers to qualify for Advanced [Alternative Payment Models] and associated bonus payments based partially on commercial contracts encourages both commercial payers and providers to offer and participate in additional contracts that tie payment to outcomes," the whitepaper reads.
2. Structural system changes. MACRA was intended to spur greater care coordination — to be successful in either the APM or the Merit-Based Incentive Payment System tracks, providers will need to seek new resources and partnerships. Leavitt Partners believes this element of MACRA will lead to increased consolidation among physician groups and health systems, in addition to growth in other more untraditional partnerships.
3. Development of new quality and efficiency measures. Lastly, Leavitt Partners believes MACRA provides an incentive to develop and refine quality and performance metrics to be more outcomes-based, rather than process-based.
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