January 1, 2019 seems like a very distant date right now. However, if you are a Physical Therapist or manage a Physical Therapy practice, that date may be closer than it seems. The Centers for Medicare and Medicaid Services (CMS) began the new MACRA program this year which focuses on transitioning healthcare from a Fee For Service payment model to a Quality Payment model. The first two years of this program are not required for Physical Therapist. However, there is an option for Physical Therapy groups to voluntarily participate in this program for the 2017 and 2018 reporting periods.
Why Should You Act Now?
- Since 2011, the majority of physician practices have participated at some level in Meaningful Use and PQRS. These two programs make up a large portion of the MACRA program.
- Physical Therapy groups have not needed to participate in Meaningful Use and most groups are not familiar with the requirements of the program.
- While many PT groups may have participated in PQRS, it was most likely via a claim submission method that did not have a direct impact on the individual therapist.
- Your payments may be negatively impacted if you are not prepared.
- Your referral business may be impacted if your competitors are planning and you are not.
What Should You Do Now to Help Your Quality Payment Score?
Implement an EHR system OR Verify Your Current EHR system is compliant.
The implementation of an EHR could be a 6-12 month process for your group. You will want to have the product installed and your clinical workflows fine tuned well before you need to begin reporting on both the Quality and Advancing Care Information components of MACRA.
If you have an EHR system in place, verify that the product is certified with the correct version. You can check for your product on the ONC certified vendor list. If you do not have a certified product, talk to your vendor to determine if a certification is on their schedule. If not, you may need to consider a new product.
Review Quality Measures & Provide Staff Education
Since many Physical Therapy groups have participated in various quality programs through claims based methods, the individual therapist may not be aware of the details behind the measures. In many instances, the billing or administrative staff simply assign the appropriate codes when necessary. This leaves the therapist unaware that quality measures are important to the visit or even what quality measures they should be focusing on.
Healthcare is transitioning from fee-for-service to Quality payment system. Everyone should know the details of the quality measures that are important to their scope of practice and most importantly, to their patients. Some of the recommended measures f0r Physical Therapy may be related to:
- Functional Status
- Coordination with Other Provider
- Preventive Care and Screening
- Disease Specific Measures
Select a Registry
As part of your quality measure review, consider subscribing to a Registry. There are many to choose from and by participating in a registry, your group will be able to better understand how they are performing. One of the biggest components of MACRA is the “competition” between providers and practices. Your final score will be published and it is important to know how practices similar to yours are performing.
How Do You Act Now to Better Your Physical Therapy Practice?
In the 2017 and 2018 reporting periods, those providers that are not eligible to participate in MACRA have the option to voluntarily report. Many groups are not taking advantage of this due to the effort involved with little incentive. However, this is a great opportunity for your practice to begin understanding the program. It will also help you score higher when you are required to participate in the program.
There are no consequences to the voluntary reporting. Your Physical Therapy practice could go through the process of MACRA and suffer no negative impact. This will greatly prepare you for the 2019 reporting requirement. You will also be ahead of the curve when everyone else needs to report.
MACRA requires a great deal of planning and coordination. It will also directly involve the clinical staff. This is a payment model change and unless you start planning now, your payments may be negatively impacted.