Wednesday 19 December 2018
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Is MACRA Here to Stay?

Is MACRA Here to Stay?

The NEWS: CMS is delaying physicians of MACRA requirements

  • The CMS sent letters to 806,879 clinicians informing them they will not be evaluated under MACRA’s Merit-based Incentive Payment System (MIPS) for this year, Modern Healthcare reported.
  • Exempted doctors are those with less than $30,000 in Medicare charges and fewer than 100 unique Medicare patients per year. Clinicians new to Medicare this year are also exempt.
  • ​About 418,000 physicians will still need to submit MIPS data. The change came after the CMS used an updated formula to estimate providers’ Medicare revenue, according to Modern Healthcare.

What does this mean?

Well for some, it means that there is an opportunity for change:

According to the American Association of Family Physicians article: the AAFP took the opportunity to send a letter to the CMS and the administration “Sensing a timely opening, the AAFP took full advantage of the opportunity to press CMS to make prudent and necessary changes regarding how the agency moves forward with implementation of the Medicare Access and CHIP Reauthorization Act (MACRA).”

The AAFP and many other healthcare organizations want to “”meaningfully improve and simplify” implementation of this law. The AAFP took the opportunity to send a letter to the CMS and the administration. “The letter cited a study ( published in the Annals of Internal Medicine in December 2016 that found physicians were spending about 50 percent of their time in the office on administrative tasks that included work related to electronic health records and only about 27 percent of their time on direct patient care.”

Under the tenure of Andy Slavitt, the CMS worked to ease requirements and improve flexibility for the massive changes MACRA imposes on physicians. Particularly in small and rural health systems, executives and physicians have raised concerns that they do not have enough time to get ready for new data gathering and reporting.

The Centers for Medicare & Medicaid Services (CMS) has announced it will award up to $30 million in grant funding to clinical specialty societies, clinical professional organizations and independent research organizations to develop quality measures under the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015 (MACRA).

According to the CMS announcement:

  • This funding opportunity will be used for developing, improving, updating or expanding quality measures for use in the Quality Payment Program under the Merit-Based Incentive Payment System and/or Advanced Alternative Payment Models.
  • Recognizing the benefits of measure development by external stakeholders with specific knowledge of clinician and patient perspectives and needs
  • The funding assistance of these cooperative agreements is specifically designated for entities such as clinical specialty societies, clinical professional organizations, patient advocacy organizations, educational institutions, independent research organizations, health systems.
  • Other entities working knowledge in quality measure development to develop quality measures that could be potentially used for the Quality Payment Program. These external entities provide the needed medical specialty and patient perspectives to lead or support the measure development priorities

“Specifically, collaboration and support for these entities in measure development will assist CMS in addressing such essential topics as: clinician engagement, burden reduction, consumer informed decisions, critical measure gaps, shared care and payment accountability quality measure alignment, and efficient data collection,” the agency wrote.

Further, CMS said the output of this work will be “one or more fully developed, specified, and tested quality measures for potential use in the Quality Payment Program tracks” of MIPS or APMs tracks.

See more about MACRA & CMS:

CMS Grant Proposal about MACRA

AAFP Presses CMS to Make MACRA Easier on Physicians

CMS gives 800,000 docs a pass on MACRA requirement

MACRA could reduce CMS physician services spending by $35B to $106B: 5 key trends



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