In a previous blog post, “Multipotentialites, Meaningful Use and MACRA,” (Part I of this two-part series), we spoke with Ben Wilson, Citrix Director, Healthcare Strategy and Healthcare Evangelist. He weighed in on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and provided context and his viewpoint on the new rules. Since our conversation, MACRA has continued to garner substantial press – both positive and negative – in the Court of Public Opinion.

On in “MACRA: Pros and Cons of Medicare Reform law Medicare Access and CHIP Reauthorization Act of 2015,” Jerry Shaw provides views on both sides, noting that one anticipated positive outcome of MACRA is that it addresses erroneous Medicare payments, provides a way to retrieve those funds and should help decrease future misappropriated payments. He cites National Law Review in support of his assessment.

Blogged Arteries, a site touting news from the Texas Medical Association, took a vastly opposing view. It published several scathing posts from two prominent North Texas physicians who believe that MACRA will be detrimental to their respective practices and to small-sized clinics in general. They dubbed the new rules “Mayan hieroglyphics” and called MACRA a game “you cannot win.”

Conversely, on another blog on MACRA, the North Carolina Medical Society notes four pluses. They range from stabilized Medicare payments and rewards for alternative payment models to physician liability protections and consolidated reporting.

And so it seems that the jury is still out in the Court of Public Opinion. With that in mind, we’ll return to Ben Wilson and the balance of his interview on MACRA. Below is the second part of our discussion:

Kathy: Ben, do you think that clinicians might be more profitable when MACRA comes into play?

Ben: I haven’t actually seen the exact numbers on how much clinicians can make above the current reimbursement level. However, MACRA is a sort of bonus program on top of today’s reimbursements. But we know that there will be bonuses – and those will be based on how physicians meet certain criteria.

Physicians stand to get 100% of the possible bonus if they score high across all of the different measures on which they’ve chosen to be assessed. (Remember that in Part I of this blog interview, it was noted that clinicians can choose the measures they feel best apply to them.) The doctors will get a lower percentage of the possible bonus payment if their scores are mediocre or lower.

Some of the profit equation also depends on the volume of patients that these clinicians have today and on the income that client base currently nets them. Then they can factor that piece of information against the bonus structure and how much more that structure enables them to earn in the event of high scores across all categories.

Kathy: Do you think MACRA will drive better care?

Ben: Yes. MACRA is described as much more provider- and patient-centric. MACRA rules do not pressure a provider to fit into a one-size-fits-all program. Providers should be able to embrace this new mandate and adjust the way that they deliver care in a way that makes the most sense for them in their particular specialty. I think that, in the end, this will be much better for patients.

In addition, there are a lot of incentives to encourage providers to innovate in terms of how they deliver care. This will also be a positive factor for patients.

Kathy: MACRA payments start in 2017, correct? Do you think the ramp-up is going to be significantly faster than it was for Meaningful Use?

Ben: Yes, although I just read an article saying that the administration is looking to delay the start of MACRA. Yet, when it actually is implemented it will be phased-in. Two years will elapse before clinicians actually get paid on the measurements. They will submit the measurements they have chosen and they will have that time get onboard with the new approach.

Because it’s simpler, it’s much more customizable. MACRA should be much easier for physicians to adopt than Meaningful Use. With approximately two years to get on board, my guess is that this should be a smooth process.

Kathy: You mentioned an article that provides more detail on MACRA?

Ben: Yes. “MACRA Proposed Rule Published by HHS, Streamlining Federal Programs Including meaningful use,” was published in Healthcare IT News. Within the article there is a link to a blog that was written by Dr. Andy Slavit, the interim director of the Department of Health and Human Services. Both the article and the blog provide in-depth information on the topic.

Kathy: How would you portray Citrix technology to the physicians who are soon to be adapting to MACRA rules?

Ben: I’d like to ensure that they know that Citrix is a strong healthcare brand that can streamline their rounds, enable a mobile workstyle and ensure secure delivery of data and applications. When clinicians think about healthcare and IT, Citrix should be one of the companies that comes to mind.

Citrix technology is a crucial part of the delivery process in 90%+ of the electronic medical records (EMRs) transactions today in the US. What’s more, the role of Citrix in healthcare is rapidly increasing internationally.

Our Healthcare Team’s mission is to continue to innovate and refine Citrix offerings so that physicians and patients always have ready access to the information they need in order to make essential care decisions – whether they are evaluating care plans in the hospital environment or working remotely, and regardless of the device used for information access. Our team is committed to increasing patient value and improving healthcare information delivery and consumption. Our ultimate goal is to play a significant role in improving the health of people worldwide.

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*If you are in the healthcare industry, we invite you to begin a dialogue with us. You can share your thoughts on the topics in this blog or any other healthcare IT issue with a Citrix researcher by clicking here.

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