October 17, 2015
Area(s) of Interest: MACRA Payor Issues and Reimbursement
The California Medical Association (CMA) and almost 90 other medical associations have sent a letter to the Centers for Medicare and Medicaid Services (CMS), asking them to expedite the release of $125 million for physician education and technical assistance as prescribed by the Medicare payment reform legislation, the “Medicare Access and CHIP Reauthorization Act of 2015” (MACRA).
On April 16, 2015, President Obama signed MACRA into law negating the Medicare sustainable growth rate (SGR) formula and replacing it with new payment systems. After more than a decade of fighting for change by CMA and others in organized medicine, the bill was passed in a monumental bipartisan action taken by Congress.
MACRA specifically authorizes a total $125 million for the education of small medical practices for the fiscal years 2015-2019, to fund the development of physician quality measures for the quality reporting programs, to help physicians report on quality and transition to new payment models. We are approaching the end of 2015 and no funds have been released for educational programs.
The letter also asks that these funds go to physician organizations with the knowledge and familiarity with small practices and specialties.
The success of MACRA is contingent upon all physician specialties having a sufficient set of actionable and relevant measures that improve patient care and allow physicians to comply with the program. Physician-led organizations are best suited to develop new measures that are useful to their members, harmonize with specialty societies’ clinical data registry activities, complement specialty developed alternative payment models and fulfill their long-term goals of improving the profession and patient care.
The letter also urges CMS to avoid technical assistance approaches that utilize large, impersonal education and communication initiatives, such as the CMS national provider calls and webinars. Large-scale, generic conference calls held at mid-day when physicians are busy treating patients have had very limited success in educating physicians on complex issues. Technical assistance must be hands-on and tailored to the needs of the individual practice, area or specialty.