John Halamka on MACRA: Overly complex rule could drive docs out of practices


The recently proposed rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA) and the new Merit Based Incentive Payment System (MIPS) is overly complex and could wind up driving many clinicians out of the industry, according to Beth Israel Deaconess Medical Center CIO John Halamka.

In a post to his Life as a Healthcare CIO blog, Halamka breaks down the IT-related parts of the rule, analyzing deadlines, objectives and the role of the Office of the National Coordinator for Health IT. Regarding the latter, he notes that providers "must attest they have cooperated with ONC surveillance and oversight activities," which he says many likely will view as "overly intrusive." Commenters to ONC's proposed rule from March--which gives ONC power to conduct direct reviews of certified health IT products--already are up in arms over those potential provisions.

In addition, Halamka predicts stakeholders could very well see the transition from Meaningful Use to "Advancing Care Information" as burdensome rather than helpful.

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"The folks at [the Centers for Medicare & Medicaid Services] are very smart and well meaning, but it's hard for me to imagine implementing the NPRM as written in the timeframes suggested," he says.

Halamka compares the proposed rule to remodeling a house, saying that eventually, improvements are impossible and a fresh start is necessary.

"Maybe the upcoming presidential transition will give us time to pause and reflect on what we've done to ourselves," he says. "As a practicing clinician for 30 years, I can honestly say that it's time to leave the profession if we stay on the current trajectory."

To learn more:
- read the full post

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