MACRA Implementation Solutions Payers, Providers Should Follow

MACRA implementation will take place across the healthcare industry starting next year, as more and more providers begin participating in Advanced Alternative Payment Models (APMs) and and the Merit-Based Incentive Payment System (MIPS). Commercial payers will need to keep up with the value-based care push coming out of the Centers for Medicare & Medicaid Services (CMS) or else they may place too much reporting and administrative burdens on their provider networks.

For instance, if private payers stick to fee-for-service payment arrangements or vary distinctly in their pay-for-performance reimbursement strategies from regulations surrounding MACRA implementation, providers will be scrambling to keep up with a wide variety of quality reporting and billing requirements.

Last week, Dr. Farzad Mostashari, Founder of Aledade Inc. and former National Coordinator for Health IT, spoke to HealthPayerIntelligence.comabout commercial payers and how they are behind CMS when it comes to alternative payment models. Mostashari explained that following the templates set up by CMS in terms of aligning with value-based care and MACRA implementation requirements is beneficial for both payers and providers.