Archived Publications eBook: MACRA is Reinventing the Structure of the P | Page 4

Under the Microscope
The Stakes Just Got
Higher - How Will
Your Practice
Respond to
the MACRA?
Karen Sorensen
Associate Vice President, National Initiatives
HealthStream
THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)
HAS FINALIZED ITS PLANS TO IMPLEMENT THE SWEEPING
PAYMENT REFORMS CALLED FOR UNDER THE MEDICARE ACCESS
AND CHIP REAUTHORIZATION ACT (MACRA) OF 2015.
In addition to repealing the Sustainable Growth Rate (SGR)
formula, the MACRA creates the Quality Payment Program
that rewards physicians and clinicians for giving better care,
not just more care. With 10,000 people entering the
Medicare program every day, CMS Acting Administrator
Andy Slavitt said that it is essential that Medicare continue
to support physicians in delivering high-quality care by
focusing on patient outcomes and reducing obstacles that
make it harder for physicians to practice good care. CMS
says that by changing the way physicians are paid, the
Quality Payment Program incentivizes quality and value
of care over quantity of services.
Despite the Trump administration’s promise to repeal major
aspects of the Affordable Care Act, Slavitt says he does not
expect any changes or slowdown to implementation of the
Quality Payment Program. The MACRA replaces the SGR,
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which was a deeply flawed reimbursement formula that was
largely viewed as bad for patients, bad for physicians, and bad
for the Medicare program. Slavitt says that by replacing the
SGR, the MACRA puts the Medicare program on more
sound footing. In addition, the law passed with very strong
bi-partisan support with just three senators and 37 congress
members voting against the legislation.
Implementation of the MACRA puts new pressure on
physicians and the organizations that employ them to
document and report performance and quality metrics.
The changes called for under the MACRA will have a
significant impact on physicians and the hospitals and
health systems with which they partner. For example,
hospitals that employ physicians directly will likely bear the
cost for compliance with the new reporting requirements,
as well as be at risk for any payment adjustments. And
there may be more pressure on physicians and their
employers to participate in alternative payment models,
such as accountable care organizations or bundled
payment programs, given the financial incentives to do so.
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Reprint from WINTER 2017 Provider Advisor