MACRA: Financial readiness

Authored by Rod Martin

There are several steps a physician organization can take to assess their financial readiness for MACRA. The first of these is to look at patient volumes and revenue associated with Medicare to determine the overall potential impact. Depending on the results, you may find you’re exempt from the program, as those organizations with less than $30,000 in revenue or 100 patients are fewer will be exempt from the program.

The next thing to look at is your costs. First, look at variable cost. Think about utilization changes as a result of more focus on quality will impact your practice. Second, review your fixed costs. There may be opportunities to reduce cost in this area that create more efficiencies and margins for your practice. Third, consider additional investment costs. For example, you may incur additional costs related to the implementation of a new EHR system to be in compliance with MACRA. Last, look at your costs and benchmark them against peer organizations such as similar sized practices or specialty groups.

Another opportunity is to look at your existing payer contracts and participation in value-based programs to determine whether there are metrics in those programs that can be used in the MACRA program.

Finally, you’ll want to prepare financial projections to determine the future potential impact of the MACRA program on your practice. Look at various scenarios including payer mix, utilization mix, macro performance and status quo. All of these will help you determine how you will perform once the MACRA program is implemented.

MACRA brings additional complexities into managing a physician practice. These are just four steps physicians can take to be more prepared for MACRA.

For more information on this topic, or to learn how Baker Tilly healthcare specialists can help, contact our team.