As the comment period for the proposed Medicare Access and CHIP Reauthorization Act (MACRA) came to a close earlier this week, the American Academy of Family Physicians (AAFP) and the American Medical Association (AMA) submitted feedback to the Centers for Medicare & Medicaid Services (CMS) and acting administrator Andy Slavitt outlining changes that could influence the way physicians transition to the new payment system.
What the AMA believes:
- Physicians should have more time before they move away from current Medicare reporting requirements, to give them a transitional period to make necessary system changes.
- Areas that have a shortage of health providers such as small, rural areas should receive exemptions and additional assistance to facilitate implementation.
- MIPS reporting requirements should be simplified by establishing a more holistic, streamlined approach that isn’t overly burdensome for physicians.
- Financial risk requirements for MACRA APMs should be revised and the APM pathway should include assistance to organizations that wish to develop and/or become participants in MACRA APMs.
What AAFP believes:
- Solo and small-group physicians should be exempt from MIPS until the framework for virtual groups — that allow individual physicians or group practices of 10 or fewer eligible professionals to join forces — is in place.
- The initial assessment period for MACRA should be delayed because the current start date gives physicians only two months to do prep work, including selecting quality measures and identifying clinical practice improvement activities.
- The complex set of measures that physicians are required to report on under MACRA do not impact the quality of care provided to patients and disproportionately affects specialities such as family medicine.
- Physicians should not be forced to pay a third-party accrediting body to receive recognition as an advanced primary care practice such as a PCMH.
What this means to independent physicians and their practices:
- Comments from the AAFP and AMA, if implemented, would ease the administrative burden for physicians and in particular, independent primary care physicians under the new laws.
- There is strong support for a second comment period that would prolong implementation but allow CMS to further refine their policies and better capture physician suggestions.
- Even though CMS still needs to address the concerns over MACRA’s implementation, the legislation is still viewed as an improvement over previous reporting programs but can be strengthened if physician input is utilized.
- For any independent physician who accepts Medicare, MACRA will lead to major change in the way practices are compensated for delivering patient care. Tracking news coverage and analysis of the law can help any practicing physician to better understand the policy and predict its impact.