MACRA: GOP Doctors Caucus ready to fix problems

capitol building above trees

Concerned that the new MACRA rule is too complicated and could result in physicians dropping out of Medicare, the co-chairs of the GOP Doctors Caucus aren’t ruling out further action by Congress to ‘fix’ the new payment system.

But doctors who don’t like the final rule that governs how Medicare will reimburse physicians under the Medicare Access and CHIP Reauthorization Act of 2015 shouldn’t count on future changes, Andrew Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, told Medical Economics.

“I’ll leave legislating to Congress because that’s what they do. If I was a physician, I wouldn’t sit back and think, ‘Maybe there will be legislation to change things,’ however,” Slavitt told the publication.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

The GOP Doctors Caucus, an 18-member group of Republican lawmakers that includes eight physicians and others with ties to healthcare, is currently reviewing the almost 2,400-page final rule released by CMS in mid-October. But its co-chairs are worried about the impact on physicians.

If they need to intervene to improve the regulations for physicians, they will, Rep. Phil Roe, M.D., of Tennessee, told Medical Economics. “If the final rule is not satisfactory, the Doctors Caucus will look at a possible legislative fix. Our top priority is getting this right for patients and practitioners,” he said.

The Caucus’ other co-chair, Rep. John Fleming, M.D., of Louisiana, is concerned many physicians will drop out of Medicare and opt for direct-pay practice models if the final rule is too onerous for doctors to meet its requirements. 

Before the final rule was released, the Caucus sent a letter to Slavitt and the Office of Management and Budget voicing its worries that a proposed payment system was too burdensome and could lead to more consolidation and higher healthcare costs. 

Both legislators say the two payment tracks under CMS’ Quality Payment Program--the Merit-based Incentive Payment System and Advanced Alternative Payment Models--are still too complex and the measures may not assess physician’s performance accurately, according to the article.

While CMS says it addressed concerns that MACRA would negatively impact small and rural physician practices, Roe and Fleming aren't convinced and  still worry MACRA will force those practices to combine with larger groups or sell out to hospitals and healthcare systems.

Suggested Articles

A report shows that Medicaid managed care can save significantly more on drugs on than traditional Medicaid. Here are highlights from the analysis.

Blue Cross Blue Shield of Michigan now has 14 participants in its Blueprint for Affordability program. Here's what that model entails.

A healthcare non-profit wants to build a “moonshot factory” to bring data science and precision health to remote villages in the developing world.