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MACRA Consulting Services

Our services define a MACRA strategy and execution plan based on the organizations strategic business objectives to maximize TIN incentives. These services are applicable to small and large physician practices, TINs encompassing multiple practices, Multiple TINs, Virtual Groups, ACO's and Advanced APMs navigating through the reimbursement transition. Have you read the rulings? We have read the rulings and we use the verbiage from the rulings in conjunction the business objectives to establish a strategy and then execute that plan with our customers.

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MACRA Advisory Services

Do you feel that there is so much information that you do not know what perspective is correct? We understand this challenge and that is why we not only advise and in conjunction provide the exact rule verbiage and page number that supports our response. There are many perspectives but their is only 1 ruling. Your organization can be confident in our advisory services.

  1. Advisory to answer questions an organization has regarding the rulings and requirements

  2. Determining the most lucrative attestation mechanism for NPI, Group, Virtual Group and Advanced APM scenarios

  3. Establish a 1-5 year operation plan to transition from NPI/Group reporting to at an risk payer agreement

  4. Determine cost control strategies based on previous QRUR reports and operational mechanisms

  5. Establish performance monitoring across all 4 (ACI, Improvement Activities, Quality and Cost) to understand and forecast overall CPS score

  6. Establish a strategy for "Other Payer APMs" in CY 2019

  7. Determine strategies to manage the financial risk in Advanced APMs through population health and risk stratification

  8. Establish strategies to address high costs and HCC scoring beneficiaries defined in the QRUR ancillary tables  

 

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QRUR Consulting Services

We will analyze your 2016 QRUR report and provide insight into quality measure domain performance and cost that includes the value modifier, composite score and the Medicare Spending per Beneficiary (MSPB) measure and associated specific conditions. All accompanying tables 1-7 are utilized to deliver the following. The next feedback from CMS will be published in July of 2018.

  1. Provider PECOS setup implications

  2. Understanding quality performance and establish operational changes to improve results

  3. Evaluate reporting mechanisms to maximize incentive opportunities

  4. Understand beneficiary attribution and validation for cost

  5. Define beneficiaries needing Primary Care Services

  6. Evaluate HCC risk score in a scatter plot and whisker plot graphs to understand beneficiary needs for care coordination

  7. Understand admitting hospital implications

  8. Assess the capital costs implications for Diabetes, Chronic Obstructive Pulmonary Disease, Coronary Artery Disease and Heart Failure and establish control plans

  9. Define the beneficiaries responsible for high costs

  10. Understand admitting diagnosis for attributed beneficiaries by episode costs for mitigation planning

 

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MACRA Program Management Services

This service includes the Advisory Service and execution of the strategy within an organization These services are excellent for physicians or groups that want to focus on their practices or have an experienced guide through the current year reporting to be self sufficient in future Quality Payment Program years.

  1.  Establish a strategy based on organization objectives and manages the implementation of the strategy through attestation

  2. Delivers a strategy scope document to achieve defined objectives

  3. Delivers a project plans outlining tasks, owners and due dates to stakeholders within the organization

  4. Defines roles and responsibilities through a RACI diagram for stakeholders

  5. Works on behalf of the organization with CMS, commercial payers and ACOs to align strategic initiatives

  6. Documents and manages risks associated with the engagement

  7. Delivers a program completion report after attestation certifying the method and documentation delivered to CMS

 

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Shared Risk Financing

We offer special service rates for individual physicians and small groups.

 

We also offer at risk payment engagements which partially funds our services based on a percentage of shared savings received by the organizations. This keeps all parties in alignment to improve patient outcomes and reduce cost.

 

Please do not wait, there is no reason for a single physician to incur a penalty associated with the Quality Payment Program.

 

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information@projectnavigation.com | 866-935-2077 | www.projectnavigation.com