July 10, 2017
Area(s) of Interest: MACRA Payor Issues and Reimbursement Practice Management
Fewer than one in four physicians feel ready to meet the Centers for Medicare and Medicaid Services (CMS) Quality Payment Program (QPP) reporting requirements, according to a survey of 1,000 physicians conducted by the American Medical Association (AMA).
QPP is the new physician payment system created by the Medicare Access and CHIP Reauthorization Act (MACRA). It replaces the fee-for-service reimbursement model with two paths to choose from: the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM).
Over half of those surveyed (56 percent) plan to participate in MIPS in 2017, which provides variable incentive payments or penalties based on certain quality and efficiency measures, while 18 percent are expecting to qualify for higher and more stable payments as APM participants.
The survey also found that a majority (51 percent) of physicians who are involved in practice decision-making feel somewhat knowledgeable about MACRA and the QPP, but only 8 percent describe themselves as “deeply knowledgeable” about the program and its requirements. Additionally, 90 percent felt the reporting requirements were “somewhat” or “very” burdensome.
AMA, the California Medical Association (CMA) and other physician groups have stressed to CMS the importance of establishing a QPP transition period. As a direct result of this advocacy, physicians only need to report on one quality measure for one patient during 2017 in order to avoid a payment penalty in 2019 under MIPS. CMS has also proposed extending the transition into 2018.
To help physicians understand the payment reforms and prepare for the transition, CMA has published a MACRA resource page at /macra. There, you will find an overview of MACRA and a comprehensive list of tools, resources and information from CMA, AMA and CMS. New to the resource center is a brief instructional video by AMA, “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting."