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AAFP issues recommendations on new payment system to CMS
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The American Academy of Family Physicians has called for CMS to provide implementation guidance on regulations it says will “help expand patients’ access to comprehensive, coordinated and efficient care” by minimizing administrative burdens for primary care physicians.
American Academy of Family Physicians (AAFP) Board Chairman Robert Wergin, MD, issued the recommendation while testifying before the U.S. House Energy and Commerce Subcommittee on Health regarding the Medicare Access and CHIP Reauthorization Act (MACRA). According to the AAFP, CMS is expected to establish regulations implementing MACRA, which replaced the sustainable growth rate formula with Medicare payment systems focusing on a value-based model.
“The AAFP has launched a comprehensive, multiyear member education and communications effort designed to simplify the transition and provide the guidance members need to realize the benefits of MACRA and value-based payment, both for their patients and their practices,” Wergin said in testimony. “Last week, we advised CMS of our concerns with how the agency might handle features of the new law.”
The AAFP’s recommendations to CMS regarding MACRA implementation include:
- addressing the “flaws in the existing fee-for-service payment system that undervalue primary care;”
- establishing an Alternative Payment Model for primary care physicians;
- using the Core Measure set, created by the Core Quality Measures Collaborative;
- re-examining the structure and documentation guidelines for evaluation and management services;
- avoiding “overly complex” regulatory implementation;
- defining the patient-centered medical home without the requirement of third-party recognition;
- allowing greater flexibility for practices during the first MACRA performance year, which begins on Jan. 1, 2017;
- adopting a 90-day reporting period for meaningful use in 2016; and
- attributing patients prospectively to the physician practice.
The testimony follows a letter regarding MACRA sent from Wergin to acting CMS Administrator Andy Slavitt dated April 11. According to the AAFP, the letter was prepared in advance of the meeting and does not address in the newly announced CPC+ payment proposal announced that same day.
“The AAFP believes that MACRA is, by intent and design, a law aimed at transforming our health care delivery system into one that is based on a strong foundation of primary care,” Wergin wrote in the letter. “A review of the law clearly demonstrates that Congress wanted a greater priority placed on comprehensive, continuous, coordinated, first contact, and connected primary care. … We recognize that a robust and well-financed health care system built on primary care is a goal that CMS also strongly supports, and we look forward to working closely with you to ensure that MACRA facilitates the achievement of that goal.”
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