The Senate should have a Doc Fix answer by the end of the day

We’re currently waiting to find out what the Senate vote will be for the Doc Fix bill that the House passed with flying colors just a little over a couple weeks ago. Senate Majority Leader Mitch McConnell said today that a decision should be made by midnight. If the legislation is passed with the needed […]

We’re currently waiting to find out what the Senate vote will be for the Doc Fix bill that the House passed with flying colors just a little over a couple weeks ago.

Senate Majority Leader Mitch McConnell said today that a decision should be made by midnight.

If the legislation is passed with the needed 60 votes, it would replace the sustainable growth rate (SGR). It isn’t totally clear what amendments might be included by the Senate – a potential 6 are to be considered, according to The Hill.

But a lot would change with this bill, which would greatly affect Medicare providers and beneficiaries. Brian Ahier shared some of the details of what would take place in his blog a few days ago. He does a good job of spelling out what some of this will mean for those involved, specifically for those in health IT.

First, the focus will be on value and quality of care instead of the current fee-for-service system.

Ahier explained section 2 of the legislation specifically:

The incentive payment program, referred to as the Merit-Based Incentive Payment System (MIPS), consolidates the three existing incentive programs, continuing the focus on quality, resource use, and meaningful electronic health record (EHR) use with which professionals are familiar, but in a cohesive program that avoids redundancies. Further, this section provides financial incentive(s) for professionals to participate in tests of alternative payment models (APMs).

Don’t worry, there are plenty of acronyms to go around.

Payments to the professionals this will apply to will be based on performance starting in 2019. The MIPS would improve the three current law incentive programs, Ahier pointed out: 

  • The Physician Quality Reporting System (PQRS) that incentivizes professionals to report on quality of care measures; 
  • The Value-Based Modifier (VBM) that adjusts payment based on quality and resource use in a budget-neutral manner; and 
  • Meaningful use of EHRs (EHR MU) that entails meeting certain requirements in the use of certified EHR systems.

There are many specifics to this potential change considering who would be affected and what the details really are with reimbursement. Read more about it in Ahier’s blog.

The bill is expected to cost $200 billion, and not everyone is pleased about that. In fact some conservative groups are demanding that Congress foot the entire bill. We’ll see how that goes.