While practices struggle with MACRA, value-based payment systems past due, expert says

Although many physician practices struggle to get on board with the new Medicare payment system implemented by MACRA, out-of-control healthcare costs leave no choice but to move to value-based payment.

That was the message Elizabeth Mitchell, president and CEO of the Network for Regional Healthcare Improvement, delivered at a congressional briefing Friday.

Given the escalating costs of healthcare, “it’s past time for this shift because the costs are unsustainable,” Mitchell said in an interview with FierceHealthcare following Friday’s briefing in which a panel, organized by the Alliance for Health Policy and The Commonwealth Fund, provided an update on implementation of the Medicare Access and CHIP Reauthorization Act.

The debate over the value of one of the payment tracks under MACRA, the Merit-based Incentive Payment System (MIPS) has gained steam in the wake of the Medicare Payment Advisory Commission recommendation this fall that the government replace the complex program with an alternative payment system. And a study released last week found a Medicare pay-for-performance program designed to improve the value of care by rewarding doctors for their performance was a failure and raised doubts about whether MIPS, which replaced it in January, will fare any better.

Mitchell, who leads a national organization of regional health improvement collaboratives working to achieve better care at lower cost, and serves as vice chair of the Physician-Focused Payment Model Technical Advisory Committee, says despite the frustration among many physicians and practices, the government must continue the push to value-based payment models.

Despite its weaknesses, “I think MIPS can be an important on-ramp for practices new to value-based models,” she said, but ultimately, healthcare must accelerate the shift to alternative payment models. At a congressional hearing earlier this month, Mitchell said physicians continue to face barriers and need support as they move to new payment models, including greater technical assistance and access to shared data.

The goals of new payment models are to improve patient care and reduce costs, she said. With that in mind, physicians need new measures that focus on those factors to truly determine whether new payment models achieve those goals.