In a review of how CMS has handled the rollout of the Medicare Access and CHIP Reauthorization Act so far, HHS' Office of the Inspector General identified two vulnerabilities that must be addressed next year.
Although overall progress has been "significant" in implementing MACRA — the law that reforms how physicians are paid under Medicare Part B — most of the work is still ahead, according to the OIG. The first performance year begins on Jan. 1, which will determine payments for 2019.
According to OIG, the two areas CMS should focus on next year to make MACRA successful are ensuring clinicians have enough guidance and technical assistance, and developing backend IT systems to support the level of data submission, validation and calculation required by the program. The OIG considers addressing these two elements as crucial to the program's success.
To evaluate the agency's progress, the OIG interviewed CMS staff and reviewed internal documents and publicly available information. The OIG found CMS, which "has historically faced challenges when implementing complex initiatives of this size," has started to learn from its past mistakes, particularly those it experienced in the HealthCare.gov rollout.
"HealthCare.gov was a really low moment for the agency, but it was a learning moment, which allowed us to learn the lessons of how to build new muscles [from the turnaround of] HealthCare.gov and apply them to the MACRA program," said an unnamed CMS official quoted in the report.
Read the full progress report here.
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