CMS proposed updates to the Quality Payment Program for 2018 last month.
The proposed QPP rule, which is updated annually as part of the Medicare Access and CHIP Reauthorization Act and will be finalized late fall, seeks to streamline reporting requirements and advance value-based care. The change drew a mix of praise and criticism from many health IT advocacy groups in its immediate wake, and athenahealth has joined the industry response in a June 29 blog post.
Here are five thoughts on the proposed rule from athenahealth Director of Government Affairs Stephanie Zaremba.
1. The updated rule continues CMS' trend toward flexibility in reporting requirements. CMS is maintaining its "pick your pace" policy by allowing clinicians to either report small amounts of data to avoid a penalty payment or report more data to strive for bonus payments.
2. Avoiding penalties will require more action in 2018. Under the new rule, clinicians would avoid a penalty by reporting on one whole category. By contrast, in 2017, clinicians would avoid a penalty by reporting a single measure within one category.
3. The proposed rule incentivizes, but does not require, adopting new technology. Providers that elect to use 2015 editioncertified EHRs will earn advanced care information category bonus points to offset reporting challenges.
4. CMS will accept "virtual group" performance in 2018. Virtual groups enable solo practitioners or group practices with 10 or fewer clinicians to perform as a joint organization.
5. The future of MACRA is uncertain, and the proposed rule highlights a "deeper problem," according to Ms. Zaremba. CMS has eased so many regulatory burdens in its proposed rule, it is unclear whether CMS will be able to implement MACRA as Congress intended.
However, Ms. Zaremba remains confident. "The bottom line is that CMS, under the Trump Administration, seems committed to steering the industry — slowly — toward value-based reimbursement. For providers in the trenches, that should be an incentive to start lining up support and putting processes in place," she writes.
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