CMS recently issued a proposed rule to update the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 to simplify reporting requirements, ensure fiscal sustainability and high-quality care within Medicare, and offer support for clinicians in 2018, according to a press release.
The move quickly drew praise from the ACP and the American Academy of Family Physicians (AAFP), as well as the AMA, which noted the measure’s emphasis on “high-quality, high-value care” and flexibility.
In describing the proposed rule, CMS cited the feedback they have received from clinicians.
“We’ve heard the concerns that too many quality programs, technology requirements, and measures get between the doctor and the patient,” Seema Verma, MPH, CMS Administrator, said in the release. “That’s why we’re taking a hard look at reducing burdens. By proposing this rule, we aim to improve Medicare by helping doctors and clinicians concentrate on caring for their patients rather than filling out paperwork. CMS will continue to listen and take actionable steps towards alleviating burdens and improving health outcomes for all Americans that we serve.”
CMS proposed new policies to encourage physician participation in either Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS), according to the release. CMS noted that it used clinician feedback to make amendments to the second year of the Quality Payment Program. If finalized, the rule would provide regulatory relief, program simplification and state and local flexibility of advanced approaches to health care delivery, as well as make it easier for small, independent and rural practices to participate, according to the release.
AMA released a statement praising CMS’ actions to provide physicians with more flexibility and help them avoid penalties under the Quality Payment Program. The organization noted that by proposing the rule CMS acknowledged its and practicing physicians’ concerns for implementing Medicare Access and CHIP Reauthorization Act (MACRA).
“In proposing these rules, the Administration has taken another step to make sure the promise of MACRA — where physicians are rewarded for improvement and for delivering high-quality, high-value care — will be fulfilled,” David O. Barbe, MD, president of AMA, said in the statement. “Patients and physicians will benefit from the new MACRA approach, as flexibility is vital when implementing a wide-ranging reform.”
“Not all physicians and their practices were ready to make the leap, and many faced daunting challenges,” he added. “This flexible approach will give physicians more options to participate in MACRA and takes into consideration the diversity of medical practices throughout the country.”
Jack Ende, MD, MACP, president of ACP, stated that ACP is encouraged by the proposed rule, noting that CMS “continues to take important steps to benefit both clinicians and patients in the delivery of high-quality, high-value care.”
According to ACP, the initial highlights of the proposal include easing the burden on small practices, zeroing out the Cost Performance Category, extending “Pick Your Pace” options, updating the Advancing Care Information Performance Category, incorporating risk adjustments for complex patients and maintaining APMs beyond the initial performance period.
AAFP stated that the regulation would help improve family physicians’ ability to participate in payment reforms successfully.
“We’re pleased that, consistent with the Department of Health and Human Services’ directive, CMS has taken steps to reduce administrative and regulatory burden,” John Meigs, Jr., MD, president of AAFP, said in the statement. “We’re equally pleased that CMS agreed with the AAFP recommendations on medical homes. For example, the financial risk borne by medical homes rolls out more slowly, providing more time for family physicians to move toward full participation in the Advanced Payment Model track. Equally important are the significant steps to reduce risk for practices of all sizes in the MIPS program.”
“We’re pleased that CMS chose to promulgate rules that are related to virtual groups. This is a solid step forward in leveling the playing field for small practices who — without a mechanism by which they can join other practices for reporting purposes — would be subject to a negative payment adjustment.”
Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of publication.