Organization: Mayo Clinic

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a high impact healthcare policy that was put in place to contain the increasing Medicare costs (Hussey, Liu, & White, 2017). The primary objective of the law was to change how healthcare providers are reimbursed by introducing pay for performance system that seeks to align healthcare providers compensation with the value of care offered (Lin, MaCurdy, & Bhattacharya, 2017). MACRA provides bonuses to the healthcare providers who provide high quality and cost-efficient care whereas those that provide low-quality care at exorbitant cost will be financially penalized (Kinker, Dobesh, Nassiri, Juzych, & Wilson, 2017). MACRA replaced the fee for service payment model with the pay for performance which seeks to change the volume of service based reimbursement which leads to increased costs without the realization of high quality care (Hussey et al., 2017). The Medicare Access and CHIP Reauthorization Act of 2015 significantly reduced the burden of care cost on the taxpayers and healthcare consumers while at the same time aiding in the improvement of care in the United States.

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Policy Assessment

Significant of MACRA on Mayo Clinic

The Medicare Access and CHIP Reauthorization Act of 2015 will have a substantial impact on healthcare providers such as the Mayo clinic by changing the approach of care and reimbursements for the Medicare patients. The policy seeks to ensure that healthcare providers such as Mayo clinic offer more quality care and at a reasonable cost to be able to qualify for bonus reimbursements (Kinker et al., 2017). Under the new policy, care will be provided and compensated based on the overall value of the care rendered. However, healthcare providers such as the Mayo Clinic does not incur any cost risk because care compensation is always above the marginal cost. Healthcare providers such as Mayo clinic does not have an incentive of overtreatment of patients, and the policy will force healthcare providers to offer services that maximize value and not quantity (Hussey et al., 2017). Mayo Clinic has been forced to reevaluate the approach of care to improve the overall care quality, and the healthcare providers will establish measures that maximize value and minimize the quantity of services.

Areas in Mayo Clinic that will be affected by MACRA

In a healthcare setting, there are key areas that will be directly affected such as the cost accounting department which is responsible for care pricing. The cost accounting department will be required to make changes that will ensure that care costing is value-based (Kinker et al., 2017). The care diagnostic department which involves the physicians will be required to ensure that care and tests are prioritized from the beginning while the marketing department will be responsible for marketing the healthcare provider as a value-based care organization. Strategic planning will be required within the healthcare organization in coordination with the human resources to ensure that the healthcare personnel such as the nurses are offered education programs to prevent policy implementation problems (Lin et al., 2017). The patient accounts department which is responsible for all of the patient billing process will be required to create a new system that bills the patients based on the value of care (Hussey et al., 2017). The pharmaceutical department of the healthcare organization should be able to stock high-value medications that do not lead to multiple patient drug administration and adheres to recommended dosages to prevent excessive medication which is a significant factor that leads to the growth of care cost.

Organization Stakeholders

Within the organization, relevant changes are needed to ensure that the healthcare organization meets the value recommendations that will be used to help the healthcare organization offer quality care services to Medicare patients (Kinker et al., 2017). As such, the areas that determine care quality and value such as the laboratory, financial department, and the physicians were profoundly affected by the Medicare Access and CHIP Reauthorization Act of 2015. The physicians should ensure that patient diagnosis is correct and the laboratory tests provide the required information for patient treatment to prevent the wrong diagnosis which increases the number of procedures and care services (Lin et al., 2017). As such, Mayo Clinic will ensure that the physicians are competent whereas the people working in the laboratory should incorporate technology to prevent mistakes that could decrease the care value (Hussey et al., 2017). The financial director in charge of care pricing in the healthcare organization will ensure that patients are not overpriced for services and the cost matches the value of care and not the quantity of services provided. Lastly, the physicians will be required to prioritize care which is an essential approach of preventing multiple treatments that are not value or care quality oriented (Kinker et al., 2017).

Community Impact

The community is primarily concerned by healthcare value, and the Medicare Access and CHIP Reauthorization Act of 2015 significantly lead to the improved care value. As such, the Mayo clinic will take into consideration what the community considers as quality and align the services with the community perception of care (Hussey et al., 2017). Mayo clinic should conduct research to understand the value perspectives of the community and the current opinion of the community on the value of the service that are already in place to ensure that the healthcare organization meets the healthcare needs of the community. In response to the Medicare Access and CHIP Reauthorization Act of 2015, Mayo Clinic should focus on quality care and care prioritization to prevent unnecessary tests and medications that increase the cost of care without an equal measure in benefit to the patients (Kinker et al., 2017).

References

Hussey, P. S., Liu, J. L., & White, C. (2017). The Medicare Access and CHIP Reauthorization Act: effects on Medicare payment policy and spending. Health Affairs, 36(4), 697-705. Retrieved from http://dayhealthstrategies.com/dhs2016/wp-content/uploads/2017/05/Health-Aff-2017-Hussey-697-705.pdf

Kinker, B., Dobesh, K., Nassiri, N., Juzych, M. S., & Wilson, M. R. (2017). The impact of the Medicare Access and CHIP Reauthorization Act on the field of ophthalmology. American journal of ophthalmology, 179, 1-9. Retrieved from https://www.ajo.com/article/S0002-9394(17)30157-5/pdf

Lin, E., MaCurdy, T., & Bhattacharya, J. (2017). The Medicare access and CHIP reauthorization act: Implications for nephrology. Journal of the American Society of Nephrology, 28(9), 2590-2596. Retrieved from https://jasn.asnjournals.org/content/28/9/2590