Because MACRA/MIPS/APMs are taking the primary care world by storm, we repeatedly hear how concerned folks are about how they are going to meet these new regulations.  

Our goal is to help folks navigate this process and improve upon the delivery.  Our philosophy is if you have to do MIPS/APMS you should do it well.  Luckily, our 7 year old Medicare Wellness Training and Software program is designed to make that easier.

With the travel necessary to visit clinics around the country I’m not always able to write an entire blog but I still wanted to stay in touch with folks who are following our adventures.

Our little Jack Russell and not so little Husky Mix travel in our RV with us.  Frankly, who wants to hear about MACRA unless there’s a cute dog picture attached to it.  Maybe these cute pictures will help digest the issues around MACRA just a little easier.

We hope you enjoy our “Where’s Buddy and Denver” segment.  

Please keep in mind, this is mostly for fun!

Our travel to Northern Iowa began the first week of September.  The goal for this trip was to interview rural and small health clinics around the Northern Midwest region.  We started our journey in northern Iowa which has several small clinics but most are associated with larger programs such as Mercy and Mayo.  There are still a few stand-alone clinics and although we visited the larger organizations, our focus was on how the smaller independent programs are functioning with the new MACRA/MIPS and APM requirements.

We were pleased to see several clinics were already implementing the Annual Wellness Visit (AWV) and Welcome to Medicare. The last time we surveyed clinics in 2013 less than 1 in 20 were doing AWVs.  We were particularly intrigued by a Mercy clinic who had completed AWVs with over 90% of their Medicare population.  Great Job Guys!  Unfortunately, we still found more clinics NOT doing the preventive service programs than we did who were actively doing them. The Medicare AWV is the foundation for meeting many of the quality measures for MIPS/APMs.

After Iowa, we spent the weekend at our friend’s incredible farm.  This farm is a sheep farm in the bluffs and goes by the name Hickory Hills Farm. (The sheep sticks taste so good they make you want to cry!) The boys had a great time playing with the sheep, chickens and other farm critters.  Chuck and I loved being in the middle of such a beautiful place.  I can’t say Chuck loved throwing hay that much though! (He thought those days were long behind him)

Hickory Hills Farm in Nelson, Wisconsin

Leaving the farm was difficult to do. I would live there if it wasn’t so cold in the winter!

Unfortunately, we didn’t have the chance to visit any clinics in Wisconsin but we were able to speak with some of the Rural Health Center program leaders and even had some time to visit a Managed Care provider near Chicago.

Certainly MACRA, MIPS/APMs are a challenge for most small and rural clinics but there are certainly those who are making progress.  We hope our research and  development of programs will make this transition a bit smoother.  To end this post I’m going to share the last campground we stayed at. This is located in Stockholm, Wisconsin and it was truly one of the most beautiful places we’ve ever stayed.

Until next time don’t forget, you can visit our study site at or just send an email or give a call.

It is our JOB to help you!!

Denver looking out over Lake Pepin. I think there was a bald eagle in the distance.

Unlike Denver, Buddy’s need to stay alert because he doesn’t want to become bald eagle bait!

Eagle in a tree in Lake Pepin region. Sorry, can barely see him/her. If ever in the area go visit the National Bald Eagle Conservatory! Amazing!!!

Campground in public park in Stockholm, Wisconsin

View from our campsite in Stockholm, WIsconsin