AMGA: Flexibility for reporting under MACRA may penalize 'high performers'


At least one major stakeholder has not embraced the Centers for Medicare & Medicaid Services’ new choices for reporting data pursuant to the Medicare Access and CHIP Reauthorization Act (MACRA), claiming that a more modest approach is unfair to doctors who anticipated the changes and adopted electronic health records and value-based care earlier.

In a statement released Sept. 12, AMGA president and CEO Donald Fisher noted that the organization, which represents multispecialty medical groups and integrated systems of care, recognizes and appreciates the need for flexibility in implementing MACRA, especially for smaller providers that may have “legitimate logistic issues” regarding its reporting requirements. However, he said, CMS’ new approach to allow providers to “pick their pace” from four different reporting potions in 2017 to avoid penalties, announced last week, hurts the “high performers.”  

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“[O]ur membership is deeply concerned that the creation of these new reporting options will have the unintended result of penalizing the very provider groups that have made the largest investments to meet MACRA’s goals of better quality, improved clinical practice activities, better use of electronic medical records, and lower resource use," Fisher said. "These groups have already begun the transition from volume to value, and it is disappointing to see their efforts will be minimized rather than rewarded, as was MACRA’s stated purpose by Congress and the Administration."

Fisher also asked that policy makers take steps to ensure that the program is fair.

“We understand that the details related to the four options are not yet fully known and may change. We ask that CMS continue to create a quality mechanism that assesses provider performance equally and that the Congress afford physician stakeholders the appropriate public forums to respond to this new refinement as well as the overall MACRA implementation,” he said.

CMS had eased up the reporting after pressure from providers and others. Many industry leaders had decried the proposed rule implementing MACRA, calling it overly complex and burdensome. The final rule is expected by Nov.1; MACRA is slated to begin Jan. 1, 2017.