Why High-Quality Care Is More Important Than EverRead Time: 4 minutes
In recent years, payment models have shifted in healthcare. Specifically, the Medicare Access and CHIP Reauthorization Act (MACRA) created a new payment program based on the quality of care. In the past, physicians were paid through a fee-for-service model. With MACRA, this has shifted to a value-based model. For the rural hospital, this means that improving efficiency and providing high-quality care is more important than ever.
What is MACRA?
MACRA was signed into effect in 2015. The new policy does a few things, one of the most important of which is to change the way physicians are paid. In particular, MACRA affects how physicians are paid for caring for Medicare beneficiaries. MACRA is responsible for the shift from fee-for-service payment models to value-based payment models. The legislation also repealed the Sustainable Growth Rate (SGR) formula and changed the payment structure.
Why was sustainable growth unsustainable?
One of the big problems with the SGR model was that the regulation lowered reimbursement for physicians but didn’t do anything to incentivize ordering fewer tests or procedures. The formula didn’t motivate physicians to provide more high-value services and fewer lower-value or unnecessary ones. Also, the regulations worked to control costs specifically for physicians, but not overall for healthcare institutions.
What does this mean for the rural hospital?
MACRA means that to maximize reimbursement, hospitals must establish clear standards of evaluation. Rural hospitals in particular often struggle to work efficiently and meet budget. With a smaller staff, community hospitals must have clear guidelines in place that determine how healthcare providers will be paid.
Improving quality of care with telehealth
One way that rural hospitals can improve quality of care is by taking advantage of telehealth resources. 24/7 remote case management is one way to enhance appropriate admissions and reduce strain on full-time employees. Telecase management centers improve efficiency and help to ensure that the right patients see the right providers. Making sure that patients see the right providers and get appropriate treatment is a big part of adhering to MACRA. Many small hospitals can benefit from having remote call centers manage patient admissions after-hours.
Finding new best practices
Any time regulations in healthcare change, hospitals need to reevaluate best practices. Rural hospitals should evaluate what MACRA means for providers and establish clear standards and guidelines. One of the best ways to improve appropriate admissions and continue offering high-quality care is through hiring a remote call center. Start the conversation today about MACRA standards and improving hospital efficiencies.