Quality Payment Program website
It’s official, the much-despised Medicare Sustainable Growth Rate formula is dead at the end of 2016. Taking its place are several options collectively known as the Quality Payment Program now that the federal government has finalized regulations to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
The Centers for Medicare and Medicaid Services announced the rule Friday, one day after taking steps to remove the reporting burden on physicians in the new program. This, according to CMS officials, will allow doctors to “pick their own pace” in complying with the regulations, which are intended to accelerate the move toward value-based care.
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The MACRA rule coincides with the release of supplemental regulations for certifying electronic health records. The Office of the National Coordinator for Health Information Technology introduced that plan on Friday.
It’s a massive rule, nearly 2,400 pages long, including the usual, long preamble explaining the rationale behind CMS decision-making.
“I can’t understate the importance of this law to the future of Medicare and to the future of the practice of medicine,” CMS Chief Medical Officer Dr. Patrick Conway said in a teleconference with reporters.
The short version is that MACRA’s Quality Payment Program contains two previously announced pathways: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models that take effect in 2017. There will be Medicare penalties for those who don’t submit any quality data to CMS.
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“Done right, we view this as an opportunity to move the focus away from paperwork and reporting,” Acting CMS Administrator Andy Slavitt said. “Physicians are hungry for these changes.”
Slavitt said that the agency will introduce an “outreach program” in the next few weeks to help educate physicians about MACRA and to help practitioners avoid the negative payment adjustments.
Slavitt estimated that CMS will pay out $1 billion in Medicare bonuses under MIPS or Advanced Alternative Payment Models, plus a smaller amount in MACRA incentive payments. He said he expected 25 percent of U.S. physicians to participate in an Advanced APM by 2018, an for that number to grow quickly.
“This is a long-term commitment,” Slavitt said. “We know that this law and this regulation are going to need to evolve as medicine evolves and as technology evolves.”
Indeed, CMS is taking the unusual step of accepting public comments on a final rule for 60 days following official publication of the rule in the Federal Register. Expect changes as MACRA goes forward. “We consider this to be a living, breathing rule,” said Slavitt.
Photo: Quality Payment Program website