What Will and Will Not Happen If/When the Affordable Care Act (ACA) Is Replaced


It is true. The Affordable Care Act (ACA) is on the chopping block. As interesting as that may or may not be, the miss-understandings regarding its effect on medical practices is huge.

Repealing the ACA will NOT change Meaningful Use (MU) requirements or any associated deadlines. MU has transitioned to MACRA (Medicare Access & CHIP Reauthorization Act).There are a host of changes in MACRA which will affect medical practices. Those changes in MACRA have deadlines for compliance and penalties associated with non-compliance.

Navigating the murky waters surrounding these two topics can be difficult, possibly treacherous. The first step is to separate them into two camps. Attack each camp on its own merit allowing for any overlap that may exist between them.

These constantly changing governances require more time and expertise to understand and implement to their full advantage than most medical practices have available on staff.

The best use of management expenditures is to engage outside consulting services. Use an ACA qualified consultant for expert guidance on the “what ifs” regarding its repeal/replacement and how to prepare. There will be changes, small and/or complex. It is just a matter of time until they are enacted. An informed consultant will educate the practice on what matters most in their business. The best qualified consultant will have hands-on experience working in a medical practice.

The author is not an ACA expert and therefore offers no specific ACA advice. Rather, it is the author’s decided opinion that seeking qualified ACA counsel is the business-prudent approach.

What is heard via the news media and software vendors should be used as a source of questions-not answers.

Turning our attention to MACRA, the terminology, the laws, the pending changes, the two methods of payment (MIPS and APM) and their combined effect on running an efficient and profitable practice decidedly differ from the Affordable Care Act. Do not use the same consultant. You will pay more for a supposedly multi-topic qualified consultant who in fact knows less about either topic, and you will likely get less than the best advice.

MACRA compliance requires significantly enhanced software. Changes in MACRA require commensurate changes in the software. Old data from a previous Electronic Medical Records system will be vital to quality care and successful reporting going forward. This is especially true based on announced changes and those planned but not yet scheduled.

All this speaks to the need for a highly qualified consultant, independent of any software vendor whose skill is also essential but separate. A MACRA Qualified Consultant will have hands-on experience working in a medical practice and is not committed to any particular software vendor.

Locating a qualified software vendor is a different task. Size and volume of sales are only one measure. References are one other source for qualifying a vendor. A live demo is essential. Be wary of a vendor who “does it all in-house”. Data conversions for example are better done by an outside firm whose specialty is data. Training is the opposite. The functionality of software is of less value when effective training and after-training-support is not available or is cost prohibitive. Trainers need to have experience in a medical office. They need to practical experience of using software in a live environment.

Changes are coming across all aspects of patient care. It is easy to confuse ACA and MACRA given the political and business landscape and constant deluge of marketing hype. Prudent medical practices will engage knowledgeable consultants to help navigate these changes and turn challenges into better patient care and improved profitability.

Source by KW Norris

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