MACRA's impact on small and rural physician practices is a big concern. Now doctors are pinning their hopes on new Health and Human Services Secretary Tom Price to make the Medicare payment system easier for them.
Price, an orthopedic surgeon who has voiced those same worries, will get his first chance to make a mark on the Medicare Access and CHIP Reauthorization Act (MACRA) with the release of a proposed Medicare rule, which is expected in the coming weeks, according to The Hill.
Doctors are hoping Price will make adjustments to MACRA to make it easier for small practices to succeed by reducing the reporting burden under the Merit-Based Incentive Payment System (MIPS) and finding additional ways for doctors to participate in advanced alternative payment models (APMs)—the MACRA pathway that offers a bigger financial reward but also requires providers to take on more risk, the report said.
The White House is currently reviewing possible 2018 updates to MACRA, the payment system that kicked in Jan. 1 and replaces the Sustainable Growth Rate formula.
One major question is whether doctors will continue to have a reprieve when it comes to reporting requirements. MACRA’s rollout allowed doctors to report a minimal amount of quality data in the first year of the program in order to avoid a penalty, and at least one person expects that to be extended. The likelihood Price will extend that flexibility is “a pretty sure bet,” John O’Shea, a surgeon and senior fellow with The Heritage Foundation, told the publication.
With one survey showing half of doctors had never even heard of MACRA, O'Shea doubts most physician practices will be ready for MIPS next year. He also questioned the value of collecting quality data.
"We make an enormous investment annually in just reporting on performance measures and basically none of the stakeholders involved think they help them in any way,” he said.
Earlier this month, Price asked doctors to recommend payment alternatives to fee-for-service models to the Physician-Focused Payment Model Technical Advisory Committee, charged with approving new APMs.
Immediately following his confirmation as HHS secretary, doctors said they would look to him to make changes to MACRA, with the Association of American Physicians and Surgeons suggesting he make the payment system voluntary.
“We make an enormous investment in performance measures and basically nobody involved thinks they help in any way.” https://t.co/fa48AlM1jP— AssocAmerPhys&Surg (@AAPSonline) April 25, 2017
The proposed rule could also contain provisions to allow for virtual groups, The Hill said, quoting CMS Chief Medical Officer Kate Goodrich.