By focusing on making it easier for clinicians to practice value-based medicine, regulators can increase the odds of driving higher-quality care.
The unveiling of the MACRA final rule only caused physicians to be more frustrated with regulations and fears of physician burnout. But it doesn’t have to be that way, write Steven Strongwater, M.D., president and CEO of Atrius Health, and Marci Sindell, chief strategy officer and senior vice president, External Affairs, of Atrius Health, in a blog post for NEJM Catalyst.
With the proper regulatory support, they see hope for achieving the Quadruple Aim, which adds physician well-being to the original Triple Aim of reduced cost of care, better population health and higher patient satisfaction.
In order to achieve that goal, they suggest several changes in regulatory emphasis:
- Consider the current and future workforce. Federal support for expanded training programs could be critical for addressing ongoing physician shortages, the authors write. They suggest better aligning the number of slots in medical schools residency programs to match demand.
- Get serious about paying for value. Despite recent moves by CMS to reform payment methodologies, the authors contend the continued use of Relative Value Units developed under the fee-for-service model mean physicians doesn’t go far enough. “If the accounting that supports total payments is not aligned to the actual work done, value-based payment may ultimately be unsustainable,” they write.
- Streamline data collection and align it with physician workflows. Since value-based care relies heavily on collecting, using and reporting data, the authors suggest regulators establish coordinated, national safety and quality metrics to reduce the level of difficulty physicians face in establishing a data infrastructure. They also encourage emphasis on “seamless interoperability” among systems so that physicians can more easily coordinate care.
- Use the government’s clout to reduce drug costs. By allowing CMS to negotiate pharmaceutical prices, regulators can exercise direct influence on the cost of care in an area where Americans currently face the highest prices in the world, the authors write.