Earlier this month, the House Ways and Means Health Subcommittee members hosted Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt to discuss the Administration’s plan for implementing the bipartisan Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). Signed into law last year, MACRA reformed how doctors are reimbursed for treating Medicare patients and creates new two tracks for payment. First, it replaces the existing Physician Quality Reporting System (PQRS), Value-Based Modifier, and “Meaningful Use” of Electronic Health Records (EHR) programs with a new, single Merit-Based Incentive Payment System (MIPS) program that expands the pay-for-performance incentives in the fee-for-service system. The second track, Alternative Payment Models (APMs), provides bonus payments for physicians who participate in Advanced APMs that hold providers financially accountable for health care costs.
At the hearing, members discussed with Slavitt the recently-released CMS proposed rule (read more in Advocacy Now online here), and how the Administration can strengthen the rule before it is finalized this summer. On both sides of the aisle, members reiterated their commitment to working with each other, working with stakeholders, and working with CMS to ensure America’s seniors receive the high-quality care they deserve. AAOS leadership and staff are closely reviewing the proposed rule and will be providing CMS with detailed comments.
“Our role as Congress is to provide oversight, and in conjunction with CMS, to provide education on how this new law will work for the various types of clinicians and provider groups,” stated House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH). “We need to answer how this rule will affect individual and small group providers versus larger groups; How will this rule affect specialty groups, versus primary care physicians? How will the timing work for implementation under some potentially tight timelines? These are questions that I hope to get clarity on today and going forward through the implementation process.”
“We know that physicians and clinicians strive to provide the best possible care for patients, and they deserve a program that encourages them to do so with flexible requirements that are as simple as possible while meeting standards of care that represent the highest quality of medicine and provide high value for the Medicare program,” Slavitt stated. “Among the many topics on which we seek feedback in the proposed rule during the comment period, this is among the most important, especially as we seek to create and enhance opportunities for small and rural practices while reducing administrative burden.”
Slavitt also stressed that they want to give physicians and clinicians more flexibility to provide what they think is the best kind of care for their patients, without unnecessary government involvement.
“As we continue to transform the Medicare program, we are working to move beyond ‘one size fits all’ measurements to an approach that offers multiple paths to value-driven care and recognizes and supports the diversity of medical practices that serve Medicare beneficiaries,” Slavitt said.
AAOS President Gerald R. Williams, Jr., MD recently commented on the importance of the proposed rule, stating that physician involvement in the development and implementation of MACRA “is critical.”
“While CMS has recognized some of our concerns, including adding flexibility to quality reporting and responding to specialty-specific needs, there are a number of issues that still need to be addressed,” Williams stated. “The importance of this proposed rule cannot be overstated. As specialty physicians, orthopaedic surgeons face unique challenges and require specialty-specific tools, measures, and other considerations in order to successfully participate in quality performance programs and APMs. We look forward to working closely with CMS to refine MACRA provisions and ensure physician payment reform ultimately improves the care of musculoskeletal patients.”
AAOS has developed a summary of the proposed rule and will be coordinating formal written comments with state and specialty societies. The deadline for comments is 5 p.m. on June 27, 2016. Find all of our MACRA news and resources at www.aaos.org/macra, read the proposed rule online here, and email us with any questions or concerns at MACRA@aaos.org.