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CMS seeks contractor to ease MACRA compliance for physicians

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Recognizing the concern that many physicians have regarding MACRA compliance, the Centers for Medicare & Medicaid Services (CMS) is searching for a contractor who can gather additional feedback and help clarify the requirements. The options under the Quality Payment Program (QPP), in particular, are confusing to independent physicians. The choice between the Merit-based Incentive Payment System (MIPS) or the Advanced Alternative Payment Models (APM) is challenging and especially crucial to provider payments.

CMS has issued a notice seeking a contractor to support all existing and future QPP system development and policy development with user research and human centered design. The task order “aims to solve current challenges faced by the Quality Payment Program (QPP), to identify and implement a consistent user experience for the clinician market, based on comprehensive user insights through market research with clinicians as well as to create a unified product strategy, visual identity, and smooth user experience across QPP products based on industry best practices.”

Cost performance will account for 30% of a provider’s MIPS score, as of 2021, and it is vitally important that the criteria for provider payments are clear. CMS recognizes that the “Cost performance category feedback presents the greatest challenge for providing feedback, since the measures are highly complex, the data is extracted from claim submissions and is not consciously submitted by clinicians. There is complex patient attribution rules, and cost normalization processes which are completely foreign to the average clinician.”

The transition of QPP to a Scaled Agile Framework (SAFe) has “created an opportunity to think holistically about the user experience for clinicians and ways in which our QPP teams can identify a product strategy, establish measurable objectives, and execute a plan aligned with the overall QPP vision through program increment planning.”

CMS has stated that the contractor will also work closely with the policy team to ensure Human-Centered Design (HCD), the process it uses to understand the people for whom it writes policies, and creates programs and services, is incorporated into policy writing.