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April 26, 2016



House Discusses MACRA Implementation

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House Discusses MACRA Implementation

The House Energy and Commerce Subcommittee on Health, chaired by Rep. Joseph Pitts (R-PA), held a hearing on April 19, 2016 examining the implementation of Medicare payment reforms included in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. MACRA was the bipartisan product of years of work to repeal the Sustainable Growth Rate (SGR) and the legislation reforms Medicare provider payments in order to streamline reporting, stabilize payments, focus on value, and encourage alternative payment models (APMs). The hearing, which followed a hearing last month that focused on CMS’ work in developing the rules for implementation (read more in Advocacy Now online here), examined how physician organizations and their members are preparing for the implementation of Medicare payment reforms.

“Through a variety of incentives, MACRA encourages physicians to engage in activities to improve quality, patient experience and outcomes and reduce costs,” stated Pitts. “Prior to MACRA, physicians not only faced the threat of unsustainable cuts from the SGR, but a series of well-meaning but uncoordinated requirements stacked on top of each other from a variety of reporting requirements. MACRA seeks to consolidate, streamline and integrate these efforts into a single program.”

Pitts stressed that there are steps practitioners can take today to start preparing for the changes, including: thinking about ways to modernize their practice and evaluating options currently available, such as Merit-based Incentive Payment System (MIPS) or Alternative Payment Methods (APMs). Read more about MIPS and APMs on the AAOS MACRA-focused webpage here:

Additionally, witnesses testified that physicians need to have robust and interoperable electronic health records (EHRs) as well as room to determine what payment models work best for them. Witnesses also stressed that MACRA implementation should be flexible and that the Centers for Medicare & Medicaid Services (CMS) should work closely with physicians to ensure a smooth and efficient transition.

Rep. Michael Burgess (R-TX) stressed that CMS should make sure doctors get feedback quickly so they can take steps to better help their patients. He also commented that the 21st Century Cures Act, which passed in the House and has been divvied up into several Senate bills (read more in Advocacy Now online here), called for creating national standards for health IT that will allow for comparing and exchanging records.

“Please don’t think we’ve taken our eye off the ball in terms of interoperability,” Burgess stated. “It remains an important factor to achieve.”

Further information, including a background memo, witness testimony and an archived video can be found on the Energy and Commerce website here. Also, the proposed rule for MACRA’s new physician reimbursement rules is expected to be released soon. Visit for updates and follow us on Twitter: @AAOSAdvocacy.