April 27, 2016
Area(s) of Interest: MACRA
Physician leaders expressed cautious optimism for the landmark Medicare payment reform law (known as MACRA) during a key congressional committee hearing on April 19. The physicians said the law represents a critical opportunity to enhance flexibility and innovation in health care that can lead to improved care and better outcomes for patients, but the law also needs to allow physicians to focus on practicing medicine by aligning and simplifying quality reporting programs.
“MACRA makes significant improvements over the current system, including the repeal of the flawed sustainable growth rate formula and giving the Centers for Medicare and Medicaid Services (CMS) an opportunity to reset and improve performance measurement as well as other requirements,” said Barbara McAneny, M.D., immediate past chair of the American Medical Association Board of Trustees. “By increasing the availability of alternative payment models, CMS will spur innovative delivery models focused on enhanced care coordination that can lead to better outcomes for patients.”
Dr. McAneny was one of four physicians who spoke at a hearing of the U.S. House Energy and Commerce Committee’s Subcommittee on Health. Together, they highlighted the three necessary steps to ensure MACRA’s successful implementation:
- Consolidating performance reporting. The new regulations will need to move away from the current pass-fail programs to accommodate the needs of all practices, specialties and patient populations. CMS also will need to streamline the existing burdensome reporting requirements and improve the timing of feedback reports for physicians.
- Broadening alternative payment models. MACRA regulations must establish a clear pathway for rapid approval and implementation of physician-focused alternative payment models that establish different approaches to delivering patient care. CMS must also avoid adding burdensome requirements that cause resources to be spent on administrative costs rather than helping patients.
- Improving measurement. The physicians pointed to needed improvements including elimination of the program flaws that make practices with high-risk patients more susceptible to penalties; timely data reports; and suitable methods for attribution and resource use.
"Currently, physicians view measurement as burdensome, inaccurate, and often outdated," said Dr. McAneny. Reporting requirements are extremely costly, she said, with estimates finding that practices spend more than 750 hours per physician annually to report quality measures, with an associated price tag of more than $15.4 billion per year nationwide. Dr. McAneny also said quality measurement reporting and data requirements should be standardized across payor type to avoid duplication.
The other physicians testifying at the hearing agreed on the great potential of MACRA if it is thoughtfully implemented based on physician feedback.
“We believe that the work needed to bring about the change in how physicians provide medical care that will make MACRA successful will mean better care for patients, better professional experience for physicians and their medical teams, and better control of health care costs,” said Robert Wergin, M.D., chair of the American Academy of Family Physicians' Board of Directors.
CMS’ proposed regulations are expected this spring.