A new proposed rule from CMS lays out how the agency plans to move forward with value-based payments for clinicians under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The rule includes a merit-based payment system (MIPS)—which consolidates the existing measures of the Physician Quality Reporting System, the Value-Based Modifier Program, and meaningful use of electronic health records—as well as Alternative Payment Models (APMs).
While the new system is intended to modernize and streamline clinician quality measures, some in the industry—including leaders from the American Hospital Association and the American Medical Association—are concerned about the rapid timeline for implementation, as well as the effects the system will have on small practices. The CEO of an ACO consulting company told Healthcare Dive that he feared smaller practices may score lower on quality measures simply due to having less “capacity to have compliance officers running around checking boxes.”
But Andy Slavitt, acting administrator of CMS, is working to reassure providers that small practices will not be harmed by the new rules. In fact, Slavitt stated that physician reporting should be easier with the new technology, and said that CMS data “shows that physicians that are in small or solo practices can do and do do just as well as physicians in larger practices.”
Concerns have also been raised about how the system will account for treatment for elderly patients and those with chronic conditions—for whom concepts like “success” and “quality” are often measured very differently. In light of this, AARP is currently advocating for payment models that give “more weight to patient experiences and patient-reported outcomes.”
The CMS comment period on the rule is open until June 27, and experts are urging healthcare providers to take advantage and give feedback now. While it’s possible some aspects of the rule will change before implementation, it’s never a bad idea for practices to make sure administrative staff have everything they need to work most efficiently.
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