The Obama administration said today it will allow for ongoing input, comment and “fewer burdens” for physicians from the newly unveiled “MACRA” final rule that ties doctor Medicare payments to quality and outcomes.
It includes more flexibility to rural and smaller practices to ease into the reporting systems with reduced requirements. “We know that this law and regulation need to evolve,” said CMS Acting Administrator Andy Slavitt on a conference call with reporters Friday morning. “We keep listening.”
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House John Boehner. Members of Congress see the move to value-based care as a natural evolution for government health programs like Medicare, with private insurers Aetna AET -0.13%, Anthem WLP +%, UnitedHealth Group UNH -0.20% and Blue Cross and Blue Shield plans already linking most reimbursement to patient outcomes rather than volume of care delivered.
MACRA repealed the flawed sustainable growth rate (SGR) formula railed against by the AMA for more than a decade because it cut payments to physicians. The SGR, part of the Balanced Budget Act of 1997, which created 17 Medicare payments cuts over more than a decade that had to be altered or reversed by Congress during that time.
The nation’s largest doctor group, the American Medical Association, indicated following Friday’s announcement of the final rule that its concerns have been addressed.
“Our initial review indicates that CMS has been responsive to many of the concerns raised by the AMA, and in the days ahead, the AMA will conduct a comprehensive review of the final rule to ensure that it promotes flexibility and innovation in the delivery of care to help meet the unique needs of all patients,” AMA President Andrew Gurman said. “With the flawed Sustainable Growth Rate (SGR) formula–and its annual threat of steep payment cuts–permanently eliminated, the new law gives many physicians the opportunity to be rewarded for the improvements they make to their practices and for delivering high-quality, high-value care to Medicare patients.”
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The rule said officials are still “finalizing the 2017 performance
period for the 2019 MIPS payment year to be a transition year as part of
the development period in the program.”Inside Obamacare: The Fix For America’s Ailing Health Care System explores the ways the Affordable Care Act will impact your health care.
“For this transition year, for MIPS the performance threshold will be lowered to a threshold of 3 points,” the final rule states. “Clinicians who achieve a final score of 70 or higher will be eligible for the exceptional performance adjustment, funded from a pool of $500 million.”
The effort to help smaller practices move away from fee-for-service medicine is landmark, analysts say.
“In creating a clear path for small, independent physicians to embrace the transition to value, CMS makes it possible for leading independent practices to reduce costs, boost outcomes and thrive,” said Dr. Farzad Mostashari, former National Coordinator for Health IT who is now chief executive at Aledade.
“The creation of viable pathways for these practices is critical to maintaining competition and personalized care in our communities. There is still work to be done to help these practices come together in virtual groups, and to stand on equal footing with larger, more integrated groups.”
source - forbes.com
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