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Pending changes to MACRA May 8, 2018

The reporting requirements for participating in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) can be an overwhelming burden for independent physicians. The Centers for Medicare & Medicaid Services (CMS) has acknowledged that burden and is considering changes to MACRA that would continue to emphasize quality care while improving the reporting processing for independent physicians.

CMS received a significant number of responses from providers when they published several requests for information (RFIs) recently. According to the Healthcare Financial Management Association (HFMA), the agency is “is looking at overhauling MACRA—including through simplification of the data submission process—as authorized by the Bipartisan Budget Act of 2018 (BBA).” CMS is reviewing each quality measure that independent physicians are required to report as part of MACRA.

Kate Goodrich, MD, director of the Center for Clinical Standards and Quality and CMO for CMS, stated that the agency is also working with electronic health record (EHR) vendors to help ease the reporting requirement burdens for independent physicians. Specifically, the agency is stressing the need to automatically extract data from the EHRs to submit to CMS, which would require little to no action on the part of independent physicians.

Goodrich emphasized, though, that there will be no more delays in the rule implementation for providers to adopt the 2015-edition EHR technology to meet the requirements of the EHR meaningful use programs. She stated that CMS has “delayed this a couple years, but last year we finalized that this would be required starting in 2019; we are not backing down on that, so we are not changing that and will reiterate that.”

Additionally, CMS is planning to offer more alternative payment models (APMs) in 2018. The agency is emphasizing physician enrollment in the new Bundled Payments for Care Improvement Advanced (BPCIA) program, CMS’s latest push on APMs. Starting in 2019, independent physicians who enroll in the BPCIA program will qualify as advanced APMs under MACRA.