New Medicare Card is just like other big changes CMS has made, right?

Nov 06, 2017

In Is the Quality Payment Program the most disruptive feature of MACRA?, two different provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) were compared, considering which might actually be more disruptive to healthcare stakeholders.

The first provision – and the major provision – is the Quality Payment Program, which moves the Medicare program away from payments based on volume of services delivered and towards payments based on the quality and efficiency of services delivered. The Centers for Medicare and Medicaid Services (CMS) estimates that MACRA will reform payments for over 600,000 clinicians across the country.

The second provision of MACRA considered was the New Medicare Card initiative. This provision requires that the federal government issue new Medicare cards to every beneficiary, and that all federal and private health information systems be ready to process newly-generated Medicare identification numbers in 2018. This provision, previously called the Social Security Number Removal Initiative, is vital and potentially very complicated.

How big is this change?

To answer the next logical question, “is the New Medicare Card initiative the biggest change in recent CMS history?,” the scope of the New Medicare Card change needs to be compared to other major logistical changes CMS has made. First, a look at the scope of the New Medicare Card change:

  1. The New Medicare Card initiative will replace Social Security Numbers with Medicare Beneficiary Identifiers, which will include 11 characters, both numeric and alphabetic. The MBI will be unique, non-intelligent, and randomly generated. As an example, CMS provides 1EG4-TE5-MK73.
  2. CMS will then need to replace Medicare cards for 150 million beneficiaries, 60 million of whom are living, and 90 million of whom are deceased.
  3. To use these new identifiers, CMS will have to replace 75 legacy information systems that are used to process claims, both within CMS and for its contractors.
  4. In addition, hundreds of thousands of private systems that handle claims will also need to be updated.

For perspective, consider that the New Medicare Card initiative will roughly double the typical number of insurance identification changes providers experience annually. In a given year, researchers estimate that 20-30% of insured Americans change health plans, meaning providers must update insurance information for roughly 58-87 million Americans who change coverage each year.1,2  These 60 million new Medicare Beneficiary Identifiers will come in addition to the typical rate at which Americans change insurance.

The change is larger than anything the system has experienced in recent history. It may be compared to the 2006 implementation of the Medicare Part D prescription drug benefit, when approximately 23 million Medicare beneficiaries changed or obtained new drug coverage. It may also be compared to the roughly 17 million individuals who gained coverage through the individual market or Medicaid in 2014.But both events pale in comparison to the 60 million active Medicare beneficiaries who will be assigned a new Medicare number.4

Further implications

So is the New Medicare Card initiative just like other big, recent changes at CMS? No, it’s bigger. And unfortunately, that could make for bigger problems. When patients experience a change in personally identifying information, such as their Medicare beneficiary number, providers face a greater risk of making errors in the patient identification process. Patient identification is the process of accurately identifying a patient and matching them to intended services, treatment, and their unique medical record. The new cards, therefore, offer the potential for a period of real chaos at the registration desk and beyond. And the potential for patient identification errors can make it hard for providers to deliver quality care.

Preparing for MACRA changes
To learn more about the New Medicare Card initiative and to understand potential impacts on patient identification, download our whitepaper, The challenges of MACRA – and how biometric patient identification can help, or watch our on demand webinar, Overcoming MACRA obstacles with positive patient identification.