AMA, ACP applaud CMS Medicare proposals

The AMA and the American College of Physicians have announced their support of a proposal to modernize Medicare payments.

CMS issued the proposal as a first step in implementing provisions of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

According to HHS, the proposed rule would implement changes through a unified framework of the Quality Payment Program, as opposed to a patchwork of programs. The Quality Payment Program would consist of two paths, via the Merit-based Incentive Payment System (MIPS) and the Advanced Alternative Payment Models (APMs).

“We are working with the medical community to advance our collective vision for Medicare payment reform,” Patrick Conway, MD, CMS acting principal deputy administrator and chief medical officer, said in a press release. “By proposing a flexible, rather than a one-size-fits-all program, we are attempting to reflect how doctors and other clinicians deliver care and give them the opportunity to participate in a way that is best for them, their practice and their patients. Reducing burden and improving how we measure performance supports clinicians in doing what they do best — caring for their patients.”

CMS stated that through MIPS, Medicare physicians are paid by demonstrating success in four categories: quality, advancing care information, clinical practice improvement activities and cost. The rule would streamline and reduce reporting burden and add flexibility. Measurement through MIPS would begin in 2017 and physicians would see payments based on those measures in 2019.

ACP noted that the proposed rule reduces the number of clinical quality measures that need to be reported, allows participants in the Quality Reporting Program to choose measures for their practice, replaces the Meaningful Use program with the Advancing Care Information Program and clarifies how Advanced Alternative Payment Models quality for fee-for-service bonus payments.

Steven J. Stack, MD, president of the AMA, responded to the proposals in a press release.

"It is hard to overstate the significance of these proposed regulations for patients and physicians," he said. "When Congress overwhelmingly passed MACRA last year, lawmakers signaled that they wanted to transform Medicare by promoting flexibility and innovation in the delivery of care, changes that could lead to improved quality and better outcomes for patients. Our initial review suggests that CMS has been listening to physicians' concerns. In particular, it appears that CMS has made significant improvements by recasting the EHR Meaningful Use program and by reducing quality reporting burdens."

The organization released online resources to help support physicians and their navigation of the care models.

“With physicians facing critical decisions about new payment models, the AMA is rolling out tools to help practices of all sizes succeed and support better health outcomes for everyone,” Stack said in a separate press release. “The AMA’s new, comprehensive online resources will help physicians drive successful implementation as insurers introduce new payment models that reward better outcomes and treatment coordination.”

Wayne J. Riley, MD, MPH, MBA, MACP, ACP president, said that the organization is "encouraged" by the proposed rule.

"The ACP is greatly encouraged that the proposed rule to implement MACRA, released yesterday by CMS, makes significant improvements in simplifying the administrative burden of quality reporting and introducing greater flexibility in meeting federal requirements relating to use of EHRs," he said in a press release. "ACP will be reviewing the proposal in more detail and providing comments on additional steps that CMS can take to reduce, simplify and harmonize quality reporting and to create multiple pathways for innovative delivery models to become APMs."

HHS will accept comments on the proposed rule until June 26. – by Chelsea Frajerman Pardes