WASHINGTON, D.C.--While the government's new physician payment policies are certain to present challenges for doctors, they are at least a step up from the previous law, healthcare leaders said Tuesday during the American Hospital Association's annual conference.
The Medicare Access and CHIP Reauthorization Act (MACRA)--which replaced the much-maligned Sustainable Growth Rate formula--represents the most profound change to physician compensation in the United States in more than 25 years, said American Medical Association President Steven Stack, M.D., (pictured right) during a panel discussion about the new reimbursement policies.
Given the gravity of those changes, he said, "there's going to be a lot of anger and frustration" from doctors working to implement MACRA, but he urged healthcare leaders to remember that "the current law is much better than what we had before."
Still, Stack said he agrees with the notion that the Centers for Medicare & Medicaid Services (CMS) has "lost physicians," adding, "I think they're so infuriated with the intrusion of so much rubbish that they can't process."
CMS has heard those complaints, though, Stack argues, and the agency seems committed to making positive changes. "We've got to stop requiring things that are inconsistent with delivering quality care, that don't matter for patients but are necessary to fulfill other program requirements," he said.
When drafting MACRA, federal health officials drew upon several high-level principles, said CMS Chief Medical Officer Patrick Conway, M.D. (pictured left).
The agency wanted to make the policies simple "as much as possible," despite the complexity of the legislation; flexible in terms of allowing providers to make choices to meet their needs; outcomes-oriented, particularly when it comes to the outcomes that hospitals and physicians want to deliver to patients; and practice-driven, rather than CMS-driven, he said.
Specifically when it comes to the law's electronic health record policies, "we tried to take a really different approach there" by making implementation not about "all or none," he said.
Even so, said Advocate Health Care Chief Medical Officer and Executive Vice President Lee Sacks, M.D. (pictured right), practices and hospitals will face a tight timeline to implement MACRA's mandates. "It'll be too late if you start tomorrow," he said.
Sacks says the law will present a number of challenges to Advocate specifically. For example, while it has enabled all of its aligned primary care physicians to use an EMR and achieve Meaningful Use, it's focused less on its specialty physicians. "This is going to call out that we're going to need to do the same" for them, he said.
What's more, he echoed others in the industry who have predicted that MACRA will push more independent practices to the breaking point.
"I am going to predict that more physicians will seek employment," he said, "and figure that it becomes the health system's problem to deal with my loss of 4 percent or 9 percent or to give me the infrastructure to be successful."
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