CMS issued the 962-page proposed rule Wednesday for the Medicare Access and CHIP Reauthorization Act to reform physician Medicare payments in the wake of the repeal of the sustainable growth rate formula.
The proposed rule was met with mixed reactions in the healthcare industry. Here we highlight five initial responses.
Tom Nickels, executive vice president, American Hospital Association
"As a strong advocate for [MACRA], the AHA believes the new physician payment programs reflect the transformation happening in healthcare that hospitals and health systems have already embraced. Today's proposed rule will have a significant impact on America's hospitals, and the more than 540,000 directly employed or contracted physicians with whom they partner to deliver quality care to patients and communities.
We are disappointed by CMS's narrow definition of alternative payment models, which could have a chilling effect on providers' ability to experiment with new patient-centered, value-driven payment models. Today's rule fails to recognize the significant resources and risk assumed by the highly motivated, early adopters of alternative payment models."
Rivka Friedman, practice manager, research and insights, The Advisory Board Company
"The proposed MACRA rule is one of the most significant developments to date that again signals the shift away from fee-for-service and toward value-based care. Though we expect to see some modifications before the program ultimately takes effect, there is no doubt this is a pivotal moment in payment reform.
Notably, the new Quality Payment Program will hold providers to unprecedented levels of accountability not just for reporting but also, among large physician groups, for their performance on a broad range of behaviors. The significant incentives to move toward downside-risk models as well as the amount of payment at stake for providers participating in MIPS reminds physicians that the development of care management and quality reporting strategies is no longer optional. Moreover, given the inherent complexity of the new payment system and its potential impact on patients, there is a tremendous amount of work to be done before the first performance year kicks off next January."
Donald Fisher, PhD, president and CEO, AMGA
"We understand the rulemaking process is part of an ongoing conversation with CMS. Based on a very preliminary look, CMS appears to have recognized the need for flexibility as providers move toward a risk-based payment system. However, we remain concerned that qualifying as an [Alternative Payment Model] remains challenging at best, even for AMGA members, many of whom are very experienced with risk-based payment models. We look forward to analyzing this rule and engaging with the agency to refine this proposal before it is finalized."
Steven Stack, MD, president, American Medical Association
"It is hard to overstate the significance of these proposed regulations for patients and physicians. When Congress overwhelmingly passed MACRA last year, lawmakers signaled that they wanted to transform Medicare by promoting flexibility and innovation in the delivery of care, changes that could lead to improved quality and better outcomes for patients.
Our initial review suggests that CMS has been listening to physicians' concerns. In particular, it appears that CMS has made significant improvements by recasting the EHR Meaningful Use program and by reducing quality reporting burdens."
Wanda Filer, MD, president, American Academy of Family Physicians
"Today's proposed regulations move toward meeting Congressional intent, which is to place greater priority on primary care that is comprehensive, continuous, coordinated, connected and a patient's first contact with the healthcare system. The law's emphasis on these priorities — and the significant attention paid to the patient-centered medical home in particular — is a direct expression of the Congressional desire to see our healthcare delivery system more aggressively promote, reward and emphasize primary care. It is important that CMS, through this regulation, get this right if we are to achieve the transformation of healthcare delivery that we all desire. We look forward to working with CMS to ensure that this regulation makes significant progress toward meeting that goal."
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