Changing Times: Aligning with MACRA for Better Care

Created by CEO Vanessa Rose Bisceglie, CareVitality was a response to MACRA legislation and changing standards for care and payment.

[Editor’s Note: This piece was contributed by Vanessa Bisceglie MBA, B.S., OHCC, PMP, NCP. Vanessa is the CEO/president of CareVitality, Inc.]

CareVitality, Inc., subsidiary of EHR & Practice Management Consultants, Inc., was created for several reasons. Among these reasons, first and foremost is my long-lived passion to help save lives utilizing healthcare technology! In creating this new subsidiary, we are able to pull from my diverse background as well as our team’s in healthcare/ healthcare technology, assisting practices to successfully participate in other government mandated programs. Our strong foundation in HIPAA privacy/security and compliance allow us to create solutions to transform practices with the new 2017 laws to provide value-based health care.

On April 15, 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed that would change the way physicians are paid based on how patients are cared for to become a more patient-centric model in healthcare. Under MACRA, participating providers (physician or mid-level) will have an increasing percentage of Medicare payments based on the quality and effectiveness of the care they provide (value focused) rather than the volume of patients as in traditional fee-for-service. Providers will earn more or less based on their performance in the quality metrics they will report and be scored on from Medicare.

Prior to MACRA going into effect January 1, 2017 the Centers for Medicare & Medicaid Services (CMS) had created multiple ways to help providers transform from the traditional fee-for-service model to this value-based care model that can help providers be reimbursed for the additional changes to their existing technology and additional care teams needed to assist in coordinating this patient-centric value based care. CareVitality has created multiple offerings to help practices navigate these offerings and fill the gaps within their organizations from our team to allow them to successfully participate in these new models.

Our parent company, EHR & Practice Management Consultants, Inc., has been providing technology services to healthcare organizations for almost eight years. We have worked with over 150 Electronic Health Record, Practice Management Systems and Patient Portal Systems and we understand the challenges practices face on a daily basis. We have assisted practices in adopting technology and participating in other incentive programs over the years. Since this new ruling came out I have been asked by many state and national medical associations to speak on the topic of MACRA and the inceptions of other programs that have come into place to help providers in transforming their practice.

We have assisted in the evolution from transforming practices to Electronic Medical Records according to a government mandate in the past. Now, we take our healthcare technology consulting, legal and regulatory experience and provide comprehensive service offerings to consult and help alleviate all the burdens providers would typically face if they implemented these programs internally.

Since our parent company’s name, EHR & Practice Management Consultants, Inc., was not very informative, we have moved into the current space using our existing skill set. I decided a new subsidiary named CareVitality is more telling of what we do. Vitality means to have the capacity for survival or for the continuation of a meaningful or purposeful existence. CareVitality provides the additional care to patients to help in their survival or better yet to lead a more meaningful or purposeful existence due to their maintained or improved health by having additional care provided to them.

CareVitality’s Care Management/ Care Coordination solutions and MACRA Consultants help maximize a provider’s value-based care reimbursements. Almost all Medicare patients are faced with multiple chronic conditions and we have devised programs where we can aid providers in caring for these patients as well as help in their transition from an acute setting back into their home environment to help avoid readmission. Since every day counts in a person’s life it is important to help these Medicare patients stay healthy for as long as possible.

CareVitality helps position providers on a roadmap to be successful with the Quality Payment Program (QPP)/ MACRA by providing a turnkey services offering which includes MIPS/ APM consulting, technology optimization and care management services to help providers successfully participate in their transition from fee-for-service to value-based care.

CareVitality helps providers increase their annual gross revenue and be successful with MACRA/ QPP with our above-mentioned offerings since by working with us we are able to assist providers to help obtain the following results for their patient population:

• Decrease in ER visits
• Decrease in hospital admissions and re-admissions
• Improvement in patient adherence
• Assists patients in improved self-management
• Helps patients improve or maintain their health with their chronic conditions
• Help uncover other chronic conditions of their patients by providing Annual Wellness Visits
• Assist in the potential prevention of chronic conditions by early detection by providing Annual Wellness Visits
• Improve patient outcomes by ongoing chronic care management (CCM)

Additionally, CareVitality can successfully assist their clients in QPP consulting and provide them these additional care management, care coordination and prevention activities to be able to gain a bonus in their Medicare payments instead of a potential decrease as discussed under MACRA.

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