Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt testified July 13 before the Senate Finance Committee on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) and implementation of physician payment reforms.
In his opening statement, Committee Chair Orrin Hatch (R-Utah) outlined MACRA’s goal of streamlining “disjointed incentive programs to reduce the administrative burden on physicians; ensure that metrics on which physicians are assessed are relevant to the patients they treat; provide flexibility to physicians to participate in a way that best fits their practice situation; and, provide an incentive to consider and attempt alternative payment models.”
Ranking Member Ron Wyden (D-Ore.) added, “Medicare payment reform took the important step of engraving in stone the principle of rewarding medical care that provides quality over quantity. For the seniors who depend on the Medicare guarantee, that ought to result in better, more thoughtful health care. That’s the direction that health care is headed in across the country, and Medicare should be leading the way.”
Senators on both sides of the aisle expressed concerns with the ability of small and rural physician practices to prepare and adhere to some of the reporting requirements by Jan. 1, 2017, under the new law. Chairman Hatch specifically asked, "Assuming that CMS releases its final incentive program rules around Nov. 1, physicians are only going to have about two months before the program goes live,” adding, “what options are CMS considering to ensure that this program gets started on the right foot?"
Slavitt explained CMS was open to multiple solutions stating, “Some of the things that are on the table that we are considering include alternate start dates, looking at whether shorter periods could be used, and finding other ways that physicians could get experience with the program before the impact of it really hits them.”
The AAMC recently submitted comments to CMS on the MACRA proposed rule and joined a June 21 letter [see Washington Highlights, July 1] with the American Medical Association (AMA) that suggested “the start date should be moved back so that physicians have time to prepare, have adequate notice of final program requirements and thresholds, a final list of qualified Alternative Payment Models (APMs) is available, and the performance period is closer to when incentive payments will be made. We believe this extra time will also be helpful for vendors, registries, and others to update their systems to accommodate the new program requirements.”