Payment Model Reform

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MACRA will create clear winners and losers.

Those who move fastest toward the Triple Aim will thrive in new payment models.

The most successful health systems and clinicians will be those that look beyond short-term compliance with payment model reform and instead seize the opportunity to transform their business models. . These winners will draw on internal and external resources to deliver exceptional, cost-effective care for individuals while building healthy, sustainable communities. 

But health systems and clinicians that take a wait-and-see approach could face significant revenue shortfalls in years to come. 

HORNE Healthcare can help you come out ahead. We collaborate with you to turn uncertainty  into clarity. We quantify the upside of participation in new payment models as well as the potential downside of non-compliance. Then we empower you with insights into your organization’s ideal strategy, as well as the steps you will need to take to come out ahead.

Payment Model Reform Solutions

Our healthcare team consists of more than 75 professionals who are immersed in healthcare, with expertise in areas such as reimbursement, valuation, tax, audit, HIPAA, and cyber. Drawing on this wealth of knowledge and insights, We  deliver the following solutions to guide our clients  through this period of profound transformation.

MIPS/APM Overview for Healthcare Leaders

Success in the new world of pay-for-value demands collaboration between clinicians and the C-suite. Our MIPS/APM Overview offers key stakeholders relevant information about MACRA, the differences between MIPS and APMs, and the potential implications and opportunities involved. When everyone starts from a common baseline of knowledge and understands the role they play, it becomes easier to align around the key opportunities and find solutions that benefit all stakeholders.

MACRA Readiness Assessment

Are you ready to pick your pace of participation? Do you have the technology and processes to report on the necessary MIPS measures? Do you have a long-term plan in place to maximize your financial rewards? A MACRA Readiness Assessment will identify the required information and process gaps long before the reporting deadline, enabling you to consider and implement appropriate strategy.

MACRA Financial Impact/Modeling

Every option within MACRA has both short- and long-term impact—from the choice of whether to participate in MIPS or an APM, to the selection of specific quality measures, to the option of reporting as a group or as individual providers.  MACRA Financial Impact/Modeling quantifies the impact of different scenarios. and lifts this burden of analysis from your shoulders so your focus stays on your patients.

Provider Compensation Model Design for MACRA

Value-based incentive programs fail without provider support. Provider Compensation Model Design draws on decades of experience designing compensation models for all types and sizes of healthcare entities to design an incentive system that works for your organization. The proposed model recommendations will align compensation with MACRA objectives and comply with all rules and regulations regarding physician compensation.

MACRA Strategy Planning

Disruptive change demands different thinking. MACRA Strategy Planning is designed to facilitate strategy discussions that allow you to anticipate and circumvent problems, creating purposeful, constructive change from the inside out. We engage stakeholders to identify short-term and long-term solutions that are best for your organization as a whole.

MACRA Integration and Due Diligence Consulting

Long term, those healthcare providers who will reap the greatest returns will participate in Advanced APMs. Success in these value-based payment models will require collaboration and integration with other healthcare providers along the continuum of care. With deep experience in healthcare M&A and valuation, HORNE Healthcare helps you examine possible integration strategies, recommending options and supporting implementation of those transactions.

MACRA Process and Outcomes Improvement Consulting

MACRA is an opportunity to increase the efficiency and quality of care for your patients. Process and Outcomes Improvement Consulting leverages our expertise in healthcare process improvement to perform ROI analyses, identify profitable services, and identify outcome improvement opportunities with the highest probability to improve quality and reduce costs.