It’s official: The reporting window for MACRA has begun. While CMS has eased the reporting requirements for 2017, calling it a transition year, practices aiming for full participation still need to report all of the required measurements for a continuous period of at least 90 days. In fact, groups looking to maximize their chances of a positive adjustment should report as much data as possible, according to CMS.

Vendors are capitalizing on these new value requirements, offering a wide range of hardware and software with promises to streamline workflows and help practices achieve the triple aim. However, not all imaging departments can start pricing out these expensive solutions without a second thought. These tools often require extensive re-training of clinical staff, allocation of IT resources to maintain and update software, and buy-in from department leaders.

Instead, the most valuable thing for providers looking to take the next step might be a self-exam. When talking to the University of Wisconsin’s Tim Szczykutowicz, PhD, about protocol management and optimization, he stressed that every organizational overhaul starts somewhere.

“Before you can try to optimize protocols, you need to document what you have now,” he said. “Whether it’s a little site that [uses] word documents, or a large academic center with complex operations, that is my number one piece of advice.”

Simply taking stock of your current standards and practices is the first step to optimization—and can result in organizational improvements at a fraction of the cost of commercial solutions.

Monitoring the patient journey for bottlenecks can shine a light on inefficient scheduling or a lack of communication between departments. Tracking how nurses or technologists spend their time can reveal non-value added activities like searching for supplies, highlighting an opportunity for reorganization.

In addition, proactive evaluation of business practices avoids the problem-based change that stems from negative trigger events; nobody wants to be involved in a practice that only changes in the face of crisis.

You can’t improve anything without a baseline, and the zero-sum nature of MACRA and MIIPS reimbursement means lagging organizations will see reduced reimbursements. All roads lead to value-based care—and taking a careful look at your practice can reveal the true picture of what needs work and what works well.