Where’s the Value in MACRA?

By DAVID INTROCASO The intent of Title I of the 2015 Medicare Access and CHIP Reauthorization Act (MACRA) is to improve care quality and reward value. 1  Tying an increasing percent of Medicare fee for service payments to quality or value through alternative payment models such as Accountable Care Organizations (ACOs) is also Department of Health and Human Services Secretary Sylvia Burwell’s goal. 2  However, in the proposed MACRA rule published in May, CMS will measure and score quality and resource use or spending independently. 3  CMS will not measure outcomes in relation to spending.  CMS will not measure for value.  If value is left unaddressed in the final rule the agency can neither meet MACRA’s goals nor Secretary Burwell’s.  CMS cannot also reasonably expect providers to continue to enter into, and succeed under, risk based contacts if they do not know if they are incrementally improving quality or outcomes relative to spending.  On background, MACRA replaced the 1997 Balanced Budget Act’s Sustainable Growth Formula (SGR) with two new methods to update annually Medicare Part B physician payments: the Merit-based Incentive Payment System (MIPS); and, the Alternative Payment Model (APM) pathway.  The MIPS will consolidate the current Physician Quality Reporting System (PQRS), the Value-based Modifier Program (VM); and, HIT Meaningful Use (MU) and will consist of four component scores: quality; resource use; clinical practice improvement ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs